Treatment of duodenal duplication by trans-umbilical exploratory minimal laparotomy.
Duodenal duplication cysts are rare congenital lesions usually diagnosed in infancy, although they may present in adulthood. Prenatal diagnosis is difficult, and postnatal diagnosis relies on ultrasonography, barium swallow, contrast-enhanced computerized tomography, magneticresonance imaging (MRI), and magnetic resonance cholangiopancreatography. A female newborn was diagnosed with an abdominal cyst (size around 6 x 5 x 4 cm) at gestational age (GA) 24 weeks, by regular prenatal examination. After her birth at GA 37 weeks, we performed abdominal ultrasonography and RI, but there was no definite diagnosis. The usual management of an abdominal cyst involves resection by laparotomy (requiring a large incision) or laparoscopy (requiring several small incisions). We performed an exploratory trans-umbilical minimal laparotomy excision for surgery, and the pathology revealed duodenal duplication. In our case, there was no recurrence of the cyst after 18 months follow-up, and the operation scar was almost undetectable. Trans-umbilical minimal laparotomy excision may be considered as an alternative choice for the management of abdominal and duodenal duplication cysts.
Chiang
Li-Lan
LL
Departments of Pediatrics, National Taiwan University Hospital and National Taiwan University College of Medicine, Taiwan.
Hsieh
Wu-Hsun
WH
Shih
Jin-Chung
JC
Hsu
Wen-Ming
WM
D003560:Cysts / Q000151:congenital* / Q000601:surgery*; D004386:Duodenum / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007813:Laparotomy / Q000379:methods*; D019060:Minimally Invasive Surgical Procedures; D016216:Ultrasonography, Prenatal; D014472:Umbilicus