Sudden unexpected death associated with ileocecal duplication cyst and clinical review

Area of Science:

• Pediatric Surgery
• Gastroenterology
• Pathology

Background:

• Alimentary tract duplications are congenital anomalies with a reported incidence of 1 in 4,500 births.
• They can occur anywhere from the esophagus to the rectum, with ileocecal duplications being relatively common.
• Symptoms vary depending on the location and size of the duplication, often mimicking other gastrointestinal conditions.

Observation:

• A one-month-old female infant presented with anorexia, vomiting, and persistent watery diarrhea.
• Initial plain abdominal radiography revealed signs of small bowel obstruction and thickened intestinal walls.
• Despite antibiotic treatment and medical management, the infant's condition rapidly deteriorated, leading to death from multiple organ failure.

Findings:

• Autopsy revealed a 3x3 cm ileocecal duplication cyst causing small bowel obstruction.
• The ileocecal duplication cyst was adhered to the ileum, which exhibited edema and necrosis.
• Histopathological examination confirmed the diagnosis of a duplication cyst as the cause of obstruction.

Implications:

• Ileocecal duplication cysts should be considered in the differential diagnosis of unexplained abdominal symptoms in infants.
• Early recognition and surgical intervention are crucial for managing this potentially fatal condition.
• This case underscores the importance of considering rare congenital anomalies in critically ill infants with gastrointestinal distress.