Gastric Duplication Cysts of the Pancreas: Clinical Presentation and Surgical Management

Introduction

Enteric duplication cysts are present in 1 out of 4 500–10 000 live births. The etiology of alimentary canal duplications is unknown, although multiple theories have been proposed including split notochord syndrome, defects in recanalization, and persisting remnants of embryonic diverticula [1]. One of the variants of enteric duplications is pancreatic gastric duplication cysts. These pancreatic lesions may present in the head, neck, body or tail of the pancreas. They can be detected by antenatal ultrasound imaging [2] [3]; however, these lesions may be missed and present later in life [4].

When these lesions are not diagnosed antenatally, pancreatic duplication cysts will often present with abdominal pain, nausea, and vomiting and can often be confused with pancreatic pseudocysts [5]. It has also been described that these lesions may be associated with chronic pancreatitis [6] [7]. Depending on the location of the lesion, operative management may vary. In a series of 4 patients with pancreatic head lesions, Siddiqui et al. reported that local resection was appropriate management without the need for a more radical resection [8]. Other groups have also described the use of laparoscopy for the management of duplication cysts located in the tail of the pancreas [9].

We describe the presentation and management of 3 patients with gastric duplication cysts located in either the body or tail of the pancreas. The lesions were all managed without a distal pancreatectomy and 1 patient was treated using a minimally invasive approach.

References

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Correspondence