Enteric Duplication Cysts as a Diagnostic and Therapeutic Challenge: Three Unique Case Reports With Review of...

Enteric duplication cysts (EDCs) are rare congenital anomalies that may occur anywhere along the gastrointestinal tract. They are typically located adjacent to the alimentary canal, sharing a common muscular wall and sometimes a lumen. The conundrum arises in the diagnosis due to difficulty in identifying the anatomical abnormality via simple radiological modalities, thereby delaying intervention. Their clinical presentation varies with location and complications. While enteric duplication cysts are uncommon, they can present with non-specific and potentially life-threatening symptoms in infancy. Accurate preoperative diagnosis requires high clinical suspicion and advanced imaging modalities, as routine investigations may appear normal. Early recognition and surgical management of EDCs are essential to prevent complications. Antenatal detection allows for early planning and surgical management. In this series, we report three pediatric cases of enteric duplication cysts presenting with distinct complications. The first case was a seven-day-old female neonate with bilious vomiting, abdominal distension, and feed intolerance since birth. Despite a normal abdominal radiograph, contrast-enhanced CT revealed a terminal ileal duplication cyst compressing the ileocecal junction and causing obstruction. The second case was a six-month-old male infant, with an undocumented antenatal suspicion of enteric cyst, presenting with acute abdomen and radiological features of perforation peritonitis. Laparotomy revealed a perforated, isolated jejunal duplication cyst. The third case was a seven-month-old female infant with recurrent intussusception, where hydrostatic reduction identified a terminal ileal duplication cyst serving as the lead point. All patients underwent successful surgical excision, with histopathological confirmation of EDC, and recovered uneventfully. This case series highlights the varied presentation, diagnostic dilemma, and timely management required for successful outcomes of enteric duplication cysts.