Related Experiment Videos
Cystic duplication of the caecum mimicking intussusception
C K Kum1, K Prabhakaran, Y S Lee
1Department of Surgery, National University Hospital, Singapore.
Insights
Diagnosis of rare cecal cystic duplications can be challenging, often mistaken for intussusception. This case highlights the importance of considering these duplications to improve diagnostic accuracy in pediatric abdominal emergencies.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Medical Imaging
Background:
- Gut duplications are rare congenital anomalies.
- Diagnosis is frequently delayed until intraoperative findings.
- They are often not considered in the initial differential diagnosis.
Observation:
- A 7-month-old boy presented with abdominal pain, rectal bleeding, and a palpable mass.
- Barium enema suggested an intussusceptum within the cecum.
- The mass was immobile, preventing hydrostatic reduction.
Findings:
- Laparotomy revealed a cystic duplication of the cecum, not intussusception.
- Rectal bleeding originated from an ulcer in the colonic epithelium overlying the cyst.
Implications:
- This case underscores the need to include cecal duplications in the differential diagnosis of pediatric intussusception-like presentations.
- Improved diagnostic accuracy can lead to earlier intervention and better patient outcomes.
- Awareness of this rare condition can aid clinicians in complex pediatric abdominal cases.
Abstract:
Diagnosis of gut duplications are often only made intraoperatively as they are uncommon and do not feature strongly in the differential diagnoses. A case of caecal cystic duplication mimicking intussusception is discussed with the aim of improving diagnostic accuracy in future cases. A 7 month old boy presented with the classical triad of abdominal pain, bleeding per rectum and a palpable mass. Barium enema revealed a mass in the caecum suggestive of an intussusceptum. Repeated attempts at hydrostatic reduction were unsuccessful as the mass was immobile. Laparotomy revealed cystic duplication of the caecum without intussusception. The bleeding per rectum was due to an ulcer in the colonic epithelium overlying the cyst.