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Erosion through the posterior gastric wall by a pancreatic pseudocyst secondary to gastric duplication
A Chawla1, D Gadaleta, K Kenigsberg
1Department of Pediatrics, North Shore University Hospital-Cornell University Medical College, Manhasset, New York 11030.
Insights
Gastric duplication cysts are rare gastrointestinal anomalies. This case highlights a unique presentation within the pancreas, emphasizing the need for timely diagnosis to prevent serious complications.
Area of Science:
- Gastroenterology
- Pediatric Surgery
- Surgical Pathology
Background:
- Enteric duplications are rare congenital malformations, with gastric duplications representing approximately 20% of these cases.
- Delayed diagnosis of gastrointestinal duplications is associated with significant morbidity and mortality.
- Gastric duplication cysts are typically found adjacent to the stomach but can occur ectopically.
Observation:
- A pediatric patient presented with a gastric duplication cyst located within the body of the pancreas.
- The gastric duplication cyst was associated with a pancreatic pseudocyst.
- The pancreatic pseudocyst ultimately eroded into the posterior wall of the stomach.
Findings:
- This case illustrates an unusual anatomical relationship between a gastric duplication cyst and a pancreatic pseudocyst.
- The erosion into the stomach wall signifies a severe complication, potentially leading to hemorrhage or infection.
- The pancreatic pseudocyst acted as a conduit or pressure source for the gastric duplication cyst's interaction with the stomach.
Implications:
- Accurate and prompt diagnosis of gastric duplication cysts is crucial, even in atypical locations like the pancreas.
- Understanding the potential for associated pancreatic pseudocysts and their complications is vital for surgical planning.
- This case underscores the importance of considering rare congenital anomalies in the differential diagnosis of complex abdominal presentations in children.
Abstract:
Gastric duplications are the rarest form of enteric duplication. They account for about 20% of all gastrointestinal duplications. Delayed and missed diagnosis leads to prolonged morbidity and mortality. We report a case of a child with a gastric duplication cyst in the body of the pancreas, associated with a pancreatic pseudocyst that ultimately eroded into the posterior wall of the stomach.