J Korean Assoc Pediatr Surg.  2017 Jun;23(1):15-17. 10.13029/jkaps.2017.23.1.15.

“Intraluminal” Pyloric Duplication: A Case Report

• Lee KD
• Kato Y
• Lane GJ
• Yamataka A

• KMID: 2384426
• DOI: http://doi.org/10.13029/jkaps.2017.23.1.15

Abstract

We report a neonatal case of "intraluminal" pyloric duplication cyst, causing gastric obstruction after birth. Endoscopy revealed a submucosal cystic lesion approximately 15 mm in size arising from the anterior and inferior surfaces of the pylorus obliterating the pyloric canal. After laparotomy, intraoperative cholangiography was performed, which documented no communication between the cyst and the bilio-pancreatic duct. Gastrotomy was performed transversally over the antrum, and the cyst delivered through the incision. The cyst was incised, the upper part of the cyst wall removed, and a mucosectomy performed on the inner cyst wall of the lower part. The mucosa and muscle of the margin of the cyst were approximated. At follow up of 10 months, the patient is well without any sign of gastric obstruction.

Keyword

Neonate; Gastric duplication; Intraluminal; Alimentary tract duplication; Duplication cyst

MeSH Terms

Cholangiography
Endoscopy
Follow-Up Studies
Humans
Infant, Newborn
Laparotomy
Mucous Membrane
Parturition
Pylorus

Figure

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  Fig. 1 “Intraluminal” cyst arising from the pyloric orifice seen on ultrasonography. The wall of the lesion had a hypoechoic outer rim and a thick echogenic inner rim or gastrointestinal signature and the lumen was hypoechoic.

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  Fig. 2 Endoscopic view showing the submucosal pyloric lesion approximately 15 mm in size.

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  Fig. 3 Intraoperative findings of the duplication cyst. A transverse gastrotomy was performed to approach the cyst from inside the stomach. The cyst was incised and a mucosectomy was performed via a gastrotomy. C, cyst; S, stomach; broken line, transverse gastrotomy.

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  Fig. 4 Histopathologic finding of the duplication cyst demonstrating gastric mucosa (H&E, ×100).

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