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Microscopic Cyst Resection for the Treatment of Patients Diagnosed with Epididymal Cyst
Published on: March 31, 2023
Ileal duplication cyst presenting with recurrent abdominal pain and postoperative Salmonella bacteremia: a case
Cheng-Yu Tsai1, Yung-Sheng Cheng2
1Department of Surgery, Tri-Service General Hospital, National Defense Medical University, Taipei, Taiwan.
Insights
This case study highlights a rare complication of ileal duplication cysts in children. Surgical removal of the cyst in a 3-year-old boy led to Salmonella bacteremia, emphasizing the need for vigilance.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Infectious Diseases
Background:
- Duplication cysts are congenital gastrointestinal anomalies, often diagnosed in early childhood.
- Ileum is the most common site, with varied clinical presentations and potential complications.
- Diagnosis can be challenging despite advanced imaging.
Purpose of the Study:
- To report a rare case of ileal duplication cyst complicated by Salmonella bacteremia.
- To highlight the potential association between surgical manipulation and postoperative infection.
- To emphasize the importance of recognizing this rare complication for patient management.
Main Methods:
- Case presentation of a 3-year-old boy with abdominal pain.
- Diagnosis of ileal duplication cyst confirmed during exploratory laparotomy and cyst resection.
- Monitoring for postoperative complications, including bacteremia.
Main Results:
- The patient was diagnosed with a non-communicating ileal duplication cyst.
- Postoperative Salmonella group C1 bacteremia occurred on day 1.
- The patient received a 10-day course of ceftriaxone and was discharged.
Conclusions:
- This is the first documented case of Salmonella bacteremia linked to surgical intervention for an ileal duplication cyst.
- Ileal duplication cysts can present with complications like partial bowel obstruction and infection.
- Awareness of potential Salmonella infection post-surgery is crucial for optimal care.
Background:
Duplication cysts are benign congenital anomalies of the gastrointestinal tract. Most manifest with symptoms within the first two years of life, and the majority are diagnosed in children (1). The clinical manifestations of duplication cysts vary depending on their location, size, and the presence of heterotopic mucosa. The most common location for these cysts is the ileum, although they can also occur in the stomach, duodenum, jejunum, colon, and rectum (2). Complications such as volvulus, intussusception, recurrent hemorrhage, and malignant degeneration have been reported (3). Despite advances in preoperative imaging, establishing a definitive diagnosis remains challenging. Enteric duplication cysts may rarely be associated with Salmonella infection and, in exceptional cases, postoperative bacteremia. Recognizing this possibility is crucial for optimal patient care.
Case Presentation:
A 3-year-old boy presented with a 3-day history of intermittent, diffuse abdominal pain. Although initial investigations were nonspecific, he was diagnosed with an ileal duplication cyst and underwent complete cyst resection during exploratory laparotomy. Macroscopic and microscopic examinations confirmed a duplication cyst comprising intestinal mucosa and muscle layers. On postoperative day 1, he developed Salmonella group C1 bacteremia and completed a 10-day course of ceftriaxone before discharge.
Conclusion:
We report a case of a non-communicating ileal duplication cyst in a 3-year-old boy, complicated by partial bowel obstruction and Salmonella group C1 bacteremia. To our knowledge, this represents the first documented case of proven Salmonella bacteremia temporally associated with surgical manipulation of an ileal duplication cyst.
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