Clinical features and management of a series of duodenal duplication cysts in children

Abstract Instructions Duplication of the duodenum is rare. This study aims to report the clinical presentation, diagnosis, and management of duodenal duplication in children. Materials and methods The case materials of children who had duodenal duplication were reviewed. Clinical manifestations, diagnostic examinations, and management methods were analysed. Results Ten cases of duodenal duplication were included. Eight were discovered before the child reached 5 years of age, whereas one was found in the second decade. The clinical manifestations were vomiting ( n = 5), abdominal pain ( n = 4), and haematochezia ( n = 1). Two patients with no presentation had a prenatal diagnosis made after ultrasound (US). US was the most frequently used diagnostic tool, and its accuracy was 90%. Four duodenal duplications were located in portion I, five were located in portion II, and one was located in portion III. Two duodenal duplications were located in the medial part of portion II, and both were connected to the main pancreatic duct (case 3 and case 9). A pancreatic pseudocyst was associated with a duodenal duplication cyst in one patient (case 3), and a fistula was found between the pseudocyst and the posterior wall of the stomach. All patients underwent surgical cyst treatment, including one mucosal stripping and nine surgical resections, two of which were laparoscopic resections of the cyst. No malignant lesions were found. Ectopic pancreas was found in two patients, and ectopic gastric mucosa was found in four patients. Conclusion The most common symptom of duodenal duplication cysts is abdominal pain, with or without vomiting. US is the most commonly used diagnostic tool. A duplication located in medial portion II is always connected to the main pancreatic duct. Complete surgical resection is recommended when the location allows it without endangering the biliopancreatic ducts. Otherwise, partial resection with mucosal stripping or internal marsupialisation should be proposed.