Intestinal duplication revealed by posterior reversible encephalopathy syndrome.

Area of Science:

• Pediatric Neurology
• Gastroenterology
• Radiology

Background:

• Posterior reversible encephalopathy syndrome (PRES) is a neurological condition characterized by seizures, altered mental status, and visual disturbances.
• Intestinal duplication cysts are rare congenital anomalies that can occur anywhere along the gastrointestinal tract.

Purpose of the Study:

• To report a unique case of an ileal duplication cyst causing posterior reversible encephalopathy syndrome (PRES) in a pediatric patient.
• To investigate the potential link between extrinsic compression by a duplication cyst and the pathogenesis of PRES.

Main Methods:

• Case report of a 13-year-old girl presenting with generalized seizures.
• Radiological assessment including magnetic resonance imaging (MRI) to identify abdominal and brain abnormalities.
• Surgical exploration and resection of the identified ileal duplication cyst.

Main Results:

• A large, thick-walled cystic lesion in the mid-abdomen was diagnosed as an ileal duplication cyst.
• The patient experienced resolution of hypertension and neurological dysfunction post-operatively.
• Follow-up brain MRI demonstrated complete resolution of cerebellar changes associated with PRES.

Conclusions:

• Ileal duplication cyst can be a potential cause of posterior reversible encephalopathy syndrome (PRES) in pediatric patients.
• Extrinsic compression of retroperitoneal structures by a duplication cyst is hypothesized as the mechanism for PRES development.
• Surgical resection of the duplication cyst led to complete clinical and radiological recovery.