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Foregut Duplication Cysts in Children
Keshawadhana Balakrishnan1, Frances Fonacier2, Shilpa Sood1
1Department of Pediatrics, Division of Gastroenterology.
Insights
Foregut duplication cysts are rare congenital anomalies in children. Surgical management depends on clinical presentation, with most patients experiencing successful outcomes.
Area of Science:
- Pediatric Surgery
- Congenital Anomalies
- Gastrointestinal Surgery
Background:
- Foregut duplication cysts are uncommon congenital malformations.
- These cysts can affect the alimentary tract from the esophagus to the stomach.
- Early diagnosis and management are crucial for pediatric patients.
Purpose of the Study:
- To review the clinical presentation, diagnostic methods, and surgical outcomes of foregut duplication cysts.
- To analyze the management strategies for these rare pediatric anomalies.
- To provide insights into the surgical decision-making process for foregut duplication cysts.
Main Methods:
- A 20-year retrospective review of patients with foregut duplication cysts.
- Analysis of clinical data including presentation, diagnosis, and surgical intervention.
- Evaluation of patient outcomes and associated congenital anomalies.
Main Results:
- Thirteen foregut duplication cysts were identified in 12 pediatric patients.
- Presentations varied, including abdominal pain, vomiting, respiratory distress, or asymptomatic findings.
- Nine patients underwent successful surgical excision without complications; others were managed conservatively or observed.
Conclusions:
- Foregut malformations in children present diverse symptoms or may be incidental findings.
- Surgical timing and approach are guided by the patient's clinical condition.
- Conservative management or observation for asymptomatic cases requires careful discussion with parents.
Background And Objectives:
Duplications of the alimentary tract are rare anomalies. We report our experience with foregut duplication cysts including their clinical presentation, diagnostic modalities, and surgical management.
Methods:
We report a 20-year retrospective review of all foregut duplication cysts managed at our institution.
Results:
Twelve patients with 13 foregut duplication cysts were identified. The ages of the children at the time of surgery ranged from infancy to adolescence, with a mean age of 7.2 years. Half of the patients presented with abdominal pain and vomiting, and the remaining either had respiratory distress or were asymptomatic. All resections were performed electively. Two of the 11 patients had other congenital anomalies, including a congenital pulmonary airway malformation and coarctation of the aorta. One patient had prenatal diagnosis by ultrasonography. Nine patients underwent complete successful excision with no complications. Three patients whose symptoms resolved during hospitalization remained under observation because of parental preference.
Conclusions:
Foregut malformation in children may present with a variety of symptoms or can be found incidentally. The decision and timing of surgery is based on the clinical presentation. Surgical intervention in asymptomatic patients should be based on a thorough discussion with the parents.
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