Editing Duplication cyst


GI duplication cyst

== Epidemiology ==
A rare congenital malformation. 1 in 4500.

Mostly symptomatic within first two years of life

Usually not communicating with bowel lumen, but can fistulate

Most common in ileum

== Pathophysiology ==

* An epithelial lining corresponding to part of the gut
* Defined layer of smooth muscle
* Close approximation with part of the gut, including possibly sharing a common wall

== Classify based on location ==

* Foregut duplication cyst
** Oesophageal
** Bronchogenic
** Neurogenic
* Midgut
* Hindgut
** A.k.a. retrorectal cystic hamartoma
** Vestige of embryonic hindgut

== Differential diagnosis ==

* Meckel's
* Congenital segmental intestinal dilatation
* Other intra-abdominal cystic lesions - mesenteric, omental, choledochal, ovarian
* Pre-sacral masses
* Intra-thoracic cysts - pericardial, thymic

== Investigation ==

* USS is good for foregut cysts
* CT picks them up, but not specific
* MRI especially good for hindgut cysts
* Technetium-99m pertechnetate scan will show presence of gastric mucosa, which is there in many cysts, especially midgut

== Complications ==

* Intussusception
* Malignant transformation
* Volvulus
* Haemorrhage

== Management ==

* Generally excised

[[Category:Small bowel]]