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Sublingual gastric duplication cyst causing respiratory obstruction: case report
E A Ameh1, A O Jimoh, A H Rafindadi
1Paediatric Surgery Unit, Department of Surgery, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria.
Insights
A rare sublingual gastric duplication cyst caused feeding difficulties and respiratory obstruction in an infant. Complete surgical excision is the preferred treatment for this uncommon congenital anomaly.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Congenital Anomalies
Background:
- Gastric duplication cysts are rare congenital anomalies resulting from abnormal development of the foregut.
- Ectopic gastric mucosa can occur in various locations, but sublingual presentation is exceptionally uncommon.
- These cysts can lead to significant clinical manifestations, including airway compromise and feeding difficulties.
Observation:
- A 4-month-old infant presented with feeding difficulties and respiratory distress attributed to a sublingual cyst.
- Initial management involved needle aspiration to relieve respiratory obstruction.
- The cyst was subsequently completely excised, and histological examination confirmed it as a gastric duplication cyst.
Findings:
- Histopathology confirmed the sublingual cyst to be of gastric origin, specifically a gastric duplication cyst.
- The case highlights an unusual ectopic location for a gastric duplication cyst.
- Complete excision proved effective in resolving the infant's symptoms.
Implications:
- This case underscores the importance of considering rare congenital anomalies in the differential diagnosis of infant respiratory and feeding issues.
- Complete surgical excision is generally recommended for gastric duplication cysts.
- In cases involving vital structures, alternative surgical approaches like cyst mucosectomy may be considered.
Abstract:
A four-month old girl presented with difficulty in feeding and respiratory obstructrion from a sublingual cyst. Respiratory obstruction was relieved by needle aspiration of the cyst, followed 14 days later by complete excision. Histology of the cyst wall confirmed it to be a gastric duplication cyst. Though the gastric mucosa has a high propensity to deviate to ectopic sites, sublingual location is uncommon. The treatment of such cysts is preferably complete excision. However, when the cyst wall is closely associated with vital structures, cyst mucosectomy or partial excision with stripping of the mucosa of the residual part may suffice.