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Distal Esophageal Duplication Cyst with Gastro-Esophageal Reflux Disease: A Rare Association and a Management
Iftikhar Ahmad Jan1, Asma Al Nuaimi2, Basma Al Hamoudi2
1Department of Pediatric Surgery, Zayed Military Hospital, Abu Dhabi, UAE.
Insights
This case report details a rare association between esophageal duplication cysts and severe Gastro-Esophageal Reflux Disease (GERD) in a pediatric patient. Surgical intervention successfully treated both conditions, improving the child
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Congenital Abnormalities
Background:
- Esophageal duplication cysts are uncommon congenital foregut anomalies.
- The co-occurrence of esophageal duplication cysts and severe Gastro-Esophageal Reflux Disease (GERD) in children is not previously documented.
Observation:
- A 16-month-old infant initially diagnosed with diaphragmatic hernia presented with hematemesis.
- Imaging revealed a distal esophageal duplication cyst and severe GERD (grade IV).
- Initial thoracoscopy failed to identify the cyst, but subsequent evaluation confirmed its presence.
Findings:
- The patient underwent successful surgical excision of the esophageal duplication cyst.
- Thoracic fundoplication was performed to address the severe GERD.
- Post-operative recovery was uneventful, with the patient doing well at 6-month follow-up.
Implications:
- This case highlights the potential association between esophageal duplication cysts and GERD in pediatric patients.
- Early and accurate diagnosis is crucial for effective management of these co-existing conditions.
- Combined surgical treatment can lead to favorable outcomes in affected children.
Abstract:
Esophageal duplication cysts are rare congenital abnormalities of the foregut and may be associated with other conditions. Association of esophageal duplication with Gastro-Esophageal Reflux Disease (GERD) has not been reported in children. We are reporting a case of a 16 months baby who had antenatal diagnosis of diaphragmatic hernia. Postnatal CTchest, however, suggested a distal esophageal duplication cyst and a contrast esophagogram showed grade-IV GER. A thoracoscopy in another hospital excluded esophageal duplication at that time. Later, he presented with hematemesis in our department and was re-evaluated. Repeat CTconfirmed a persistent 2.5 x 1.3 cm cyst in distal esophagus. Upper GI endoscopy suggested grade-II esophagitis with a wide patent gastro-esophageal junction. The child was treated with left thoracotomy, excision of the duplication cyst and thoracic fundoplication. He had an uneventful post-operative recovery and is doing well at 6 months follow-up.
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