Repeated ultrasound tests could be used to identify an isolated gastric duplication cyst before surgery

Area of Science:

• Pediatric Surgery
• Medical Imaging

Background:

• Intra-abdominal cysts can present with varied symptoms, making diagnosis challenging.
• Early identification is crucial for effective management of pediatric abdominal masses.

Observation:

• A toddler girl presented with a 6-day persistent fever, leading to emergency room admission.
• Contrast-enhanced CT scan showed an enlarged intraperitoneal cyst with heterogeneous wall enhancement.
• Continuous ultrasound follow-up revealed a distinctive double-wall sign and cyst peristalsis.

Findings:

• The observed imaging features, particularly the double-wall sign and peristalsis on ultrasound, supported a preoperative diagnosis of a duplication cyst.
• Infection of the simple cyst was suspected due to fever and CT findings.

Implications:

• This case highlights the utility of serial ultrasound in diagnosing pediatric duplication cysts, especially when clinical presentation is atypical.
• The double-wall sign is a key sonographic indicator for duplication cysts.
• Accurate preoperative diagnosis can guide surgical planning and improve patient outcomes.