title: Pyloroduodenal duplication cysts: treatment of 11 cases.
abstract: BACKGROUND
  Abdominal enteric duplications are found in 1 out of 4,500 autopsies, and only 4 to 5% of them are located in the duodenum, where they may be connected with the biliary or pancreatic ducts. The aim of this study was to describe the clinical features, management, and outcome of a large series of duodenal duplication cysts.
  
  
  METHODS
  The charts of all patients treated at our institution between 1985 and 2011 were reviewed retrospectively with particular attention to imaging, surgical technique, pathology, and outcome.
  
  
  RESULTS
  During that period, 11 cases (81.8% females) were treated. Out of the 11 patients, 8 were symptomatic (vomiting in 3, recurrent acute pancreatitis in 2, and abdominal pain in 3) and 3 were tentatively diagnosed prenatally as choledochal cysts. Median age at surgery was 2.3 years (0 to 13.7) and preoperative diagnosis was correct in five cases. Five cysts were developed intraluminally and three communicated with the biliary duct (one), pancreatic duct (one), or both (one). Surgical treatment consisted of complete resection (four cases, including one pancreaticoduodenectomy), partial removal including all mucosa (four cases), and internal marsupialization (three cases). In all cases, the ductal communications were divided and opened into the duodenal lumen. In six cases, ectopic gastric mucosa was found. All patients recovered uneventfully.
  
  
  CONCLUSIONS
  Duodenal duplication cysts are rare and may have bizarre anatomical patterns due to biliopancreatic involvement. Optimal treatment is complete surgical removal, and, if this is not possible, partial removal including the mucosa or marsupialization are also good alternatives. In cases with biliary and pancreatic tract connections, these have to be taken down carefully and drained into the duodenum.
authors: Department of Pediatric Surgery, Hospital Universitario La Paz, Madrid, Spain. slopezf.hulp@salud.madrid.org
authors: Sergio
authors: S
authors: Lopez-Fernandez
authors: Sara
authors: S
authors: Hernandez-Martin
authors: María
authors: M
authors: Ramírez
authors: Rubén
authors: R
authors: Ortiz
authors: Leopoldo
authors: L
authors: Martinez
authors: J A
authors: JA
authors: Tovar
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D015529:Choledochal Cyst / Q000175:diagnosis / Q000601:surgery; D003560:Cysts / Q000175:diagnosis* / Q000601:surgery*; D003937:Diagnosis, Differential; D013505:Digestive System Surgical Procedures / Q000379:methods*; D004386:Duodenum / Q000002:abnormalities* / Q000601:surgery*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D016577:Pancreaticoduodenectomy / Q000379:methods; D011706:Pyloric Antrum / Q000002:abnormalities* / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome