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Variety Of Gastrointestinal Duplications In Children: Experience At Tertiary Care Hospital
Shazia Perveen1, Sajid Ali1, Shumaila Israr1
1National Institute of Child Health, Jinnah Sindh Medical University, Karachi, Pakistan.
Insights
Gastrointestinal duplication cysts are rare developmental anomalies. This study highlights their varied presentations, diagnostic challenges, and surgical management in five pediatric patients, emphasizing prompt diagnosis and complete excision for optimal outcomes.
Area of Science:
- Pediatric Surgery
- Developmental Biology
- Gastroenterology
Background:
- Gastrointestinal (GI) duplication is a rare congenital anomaly.
- These duplications can occur anywhere along the GI tract, with a predilection for the ileum.
- Understanding their presentation and management is crucial due to their rarity.
Purpose of the Study:
- To document the experience with gastrointestinal duplication in pediatric patients.
- To analyze the presentation, diagnostic methods, and management challenges.
- To report on the complications and outcomes associated with these rare anomalies.
Main Methods:
- A descriptive case series was conducted over 1.5 years.
- Data collected included patient demographics, clinical presentation, investigations, surgical procedures, lesion characteristics, histopathology, complications, and outcomes.
- Analysis focused on the evaluation and management of five pediatric cases.
Main Results:
- Five patients, ranging from antenatal diagnosis to 12 years old, were managed.
- Presentations included duodenal, thoracoabdominal, gastric, jejunal, and ileal duplications, with two cases presenting with perforation.
- Diagnosis utilized clinical evaluation, X-ray, ultrasound, and CT scans; all cysts were successfully resected, with one postoperative mortality due to liver failure.
Conclusions:
- Enteric duplications exhibit diverse clinical presentations based on anatomical location.
- Prompt diagnosis and complete surgical excision are the primary treatment goals.
- These rare duplications pose significant surgical challenges.
Background:
Gastrointestinal duplication is a rare developmental anomaly that can be present anywhere along the GI tract, most often being found in ileum. The purpose of this study is to share our experience in evaluation of the presentation, investigations, management challenges and complications of patients with this very rare condition.
Methods:
This descriptive case series was conducted at the Department of Paediatric Surgery, National Institute of Child Health Karachi, Pakistan, from April 2018 to October 2019. Data was analysed with regard to age, clinical presentation, investigations, surgical procedures, site and type of lesion, histopathology, complications and outcomes.
Results:
A total of five patients were managed in one and half year. The patients' ages ranged from antenatally diagnosed foetus to 12 years old child. New-born who presented with antenatal diagnosis of abdominal cyst turned out to have duodenal duplication cyst. Among other four were thoracoabdominal duplication cyst, gastric duplication, jejunal duplication and ileal duplication, last two presented with perforation. Other presentations were abdominal pain, swelling and vomiting. Diagnosis was made on clinical ground, x-ray of abdomen, ultrasound and computed tomography. All cysts were resected successfully and patients remained asymptomatic till one year follow up except one patient who expired postoperatively due to liver failure.
Conclusions:
Enteric duplication can present in variety of ways depending on anatomical location. Prompt diagnosis and complete excision of cyst is the aim of treatment. However, these rare types of duplication are a challenge to operating surgeons.
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