Parenchyma-sparing resection for a complex jejunal duplication with a shared mesenteric blood supply: a case report

Gastrointestinal (GI) duplication cysts present significant diagnostic and surgical challenges, particularly with complex anatomy. We report a 2-year-old male with chronic obstructive symptoms caused by a mixed-type jejunal duplication. While initial ultrasound was equivocal, contrast-enhanced computed tomography delineated a cystic mass on the mesenteric border, guiding surgical planning. Intraoperatively, a shared mesenteric blood supply with the native jejunum precluded complete resection. A parenchyma-sparing partial excision of the symptomatic, non-communicating portion was performed, preserving the fused communicating segment. Histology confirmed the diagnosis. The patient's recovery was uneventful, with complete symptom resolution at follow-up. This case illustrates that for complex GI duplications, a tailored, parenchyma-sparing resection is a safe and effective strategy when vascular integrity is at risk, shifting the clinical focus from acute management to the necessity of long-term surveillance for the retained segment.