回腸重複嚢胞の症例報告：再発性腹痛および術後サルモネラ菌血症

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.

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.

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.