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An ileal duplication cyst manifested as an ileocolic intussusception in an adult
Hyun-Soo Kim1, Ji-Youn Sung, Won Seo Park
1Aerospace Medical Research Center, Republic of Korea Air Force, Chungcheongbuk-do, Republic of Korea. kimyw@khu.ac.kr.
Insights
An ileal duplication cyst, a rare condition, caused intussusception in an adult. This case highlights the importance of considering these cysts in adult intussusception diagnoses.
Area of Science:
- Gastroenterology
- Surgical Pathology
Background:
- Enteric duplication cysts are rare congenital anomalies.
- Intussusception is uncommon in adults and often associated with a pathological lead point.
Observation:
- A 19-year-old woman presented with right upper quadrant pain and was diagnosed with ileocolic intussusception.
- Imaging revealed a cystic mass at the intussusceptum tip, confirmed microscopically as an ileal duplication cyst with heterotopic gastric mucosa.
Findings:
- This case represents the first documented instance of an ileal duplication cyst acting as a pathological lead point for adult ileocolic intussusception.
- The cyst wall exhibited a smooth muscle coat and heterotopic gastric mucosa.
Implications:
- Enteric duplication cysts should be considered in the differential diagnosis of adult intussusception, particularly those with cystic lead points.
- This finding expands the understanding of rare causes of intussusception in the adult population.
Abstract:
An enteric duplication cyst presenting as enterocolic intussusception is an exceptional clinical entity. We herein report a rare case of an ileal duplication cyst that manifested as an ileocolic intussusception. A 19-year-old woman was hospitalized due to right upper quadrant pain. Colonoscopy revealed a polypoid mass protruding into the colonic lumen. Ultrasonography demonstrated intussusception with a teardrop-shaped cystic mass at the tip. Computed tomography also showed ileocolic intussusception with a 2.5 cm-sized round cystic mass at the tip of intussusceptum. Microscopically, the cystic wall consisted of a well-defined smooth muscle coat and heterotopic gastric mucosa, consistent with an enteric duplication cyst. This case highlights an ileal duplication cyst as an uncommon cause of adult ileocolic intussusception. To the best of our knowledge, this is the first case of enteric duplication cyst identified as a pathological lead point for enterocolic intussusception in an adult. Enteric duplication cysts should be included in the differential diagnosis of cystic-leading lesions for adult intussusceptions.
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