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Gastrointestinal duplication cyst is a rare congenital anomaly with a reported incidence of 1 in 4500 live births. Any part of gastrointestinal tract from mouth to anus can be affected with this anomaly. Among gastrointestinal tract duplications, gastric duplication cyst is extremely rare (2-9%). We are presenting a case of the stomach duplication in a four (04) day old male child who presented in our Emergency Department with complaints of non-bilious, non-projectile vomiting and visible bulge in upper abdomen since birth. Workup showed enteric duplication cyst which was excised.Complete surgical resection is the treatment of choice in gastric duplication cyst.Keywords:Gastrointestinal duplication; Alimentary tract duplication; Gastric outlet obstruction; PakistanCitation:Khattak MAK, Nisar MU, Sikandar S, Akhtar N. Gastric duplication cyst: A rare congenital anomaly causing Gastric Outlet Obstruction. J Ayub Med Coll Abbottabad 2019;31(3):466–8.INTRODUCTIONGastrointestinal duplication cyst is a rare congenital anomaly which can occur anywhere from mouth to anus. The incidence of gastrointestinal tract duplication is 1 in 4500 live births.1 Duplication of gastrointestinal tract is more common in ileum, followed by oesophagus and colon.2 Duplicationcyst of stomach is extremelyrare among alimentary tract duplication, accounting for only 2–9% of all gastrointestinal duplications.3 Majority of the case are diagnosed in early childhood or teenage. However, cases in old age have also been reported in literature.4CASE REPORTA four (4) day old male child presented in our Emergency Department with complaints of non-bilious, non-projectile vomiting and visible bulge in upper abdomen since birth. On examination, the child was mild dehydrated and in obvious respiratory distress. After initial management and stabilization, an X ray erect abdomen was done that showed mass effect confined to right hypochondrium and epigastric regions, obscuring the gas shadows of the gut. CT abdomen with IV and oral contrast was done and it showed enteric duplication cyst. On 7th day of life, child underwent exploratory laparotomy and cyst measuring 8×10 cm, arising from pylorus was found. Cyst was not communicating with gut. Cyst along with first part of the duodenum were excised gastro duodenostomy was done. Cyst contained mucinous fluid and was sent for histopathology. Post operatively the child was kept NBM for five (05) days and partial Total Parenteral Nutrition (TPN) was given during that period. Controlled oral feed was started on 6th post-operative day and child was discharged on 10thpost-operative day after establishing demand feed tolerance. Histopathology confirmed presence of both gastric and enteric mucosa.Figure-1: X-Ray abdomen showing mass in right hypochondrium displacing gut loops (white arrows)Figure-2: CT scan abdomen showing Gastric duplication cyst (black arrows)
Muhammad Umar Nisar,, Muhammad Umar Nisar,, Samer Sikander. (2019) GASTRIC DUPLICATION CYST: A RARE CONGENITAL ANOMALY CAUSING GASTRIC OUTLET OBSTRUCTION, JOURNAL OF AYUB MEDICAL COLLEGE ABBOTTABAD, Volume 31, Issue 3.
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