Enteric duplications presenting as antenatally detected abdominal cysts: is delayed resection appropriate?
OBJECTIVE
The aim of this study was to evaluate delayed elective resection of antenatally detected enteric duplication cysts.


METHODS
A retrospective casenote study of intraabdominal cysts detected antenatally between January 1991 and January 2002 found 37 fetuses with cysts. Twelve were enteric duplications. Two were duodenal, 1 was an 85-cm tubular jejunoileal duplication, and 9 were ileocecal. Asymptomatic cysts were followed with serial ultrasound scars and resected electively over 14 months.


RESULTS
Three neonates had small bowel obstruction demanding laparotomy: 1 of the 2 infants with duodenal duplication cysts, 1 infant with an ileocecal duplication, and the infant with the tubular duplication. One with an ileocecal duplication became symptomatic at 2 months and underwent a laparotomy. Seven had their duplications resected electively between 6 weeks and 14 months, and the other is still being followed. Four of the 7 asymptomatic duplications electively resected contained gastric mucosa.


CONCLUSIONS
Intraabdominal enteric duplication cysts are increasingly likely to be detected antenatally. The majority are likely to remain asymptomatic for several months at least, after which a resection can be planned. The prevalence of gastric mucosa suggests that they should not be left indefinitely. Laparoscopically assisted resection of ileocecal duplications is safe and effective.
Foley
P T
PT
Department of Paediatric Surgery, The Women's and Children's Hospital, North Adelaide, SA, Australia.
Sithasanan
N
N
McEwing
R
R
Lipsett
J
J
Ford
W D A
WD
Furness
M
M
D003560:Cysts / Q000000981:diagnostic imaging* / Q000601:surgery; D004065:Digestive System Abnormalities / Q000000981:diagnostic imaging / Q000601:surgery; D004386:Duodenum / Q000002:abnormalities* / Q000000981:diagnostic imaging; D005260:Female; D005315:Fetal Diseases / Q000000981:diagnostic imaging; D006801:Humans; D007082:Ileum / Q000002:abnormalities* / Q000000981:diagnostic imaging; D007223:Infant; D007231:Infant, Newborn; D011247:Pregnancy; D012189:Retrospective Studies; D016216:Ultrasonography, Prenatal