Gastric outlet obstruction caused by duplication of duodenum - A case report and review of literature

Gastrointestinal tract duplications are rare congenital lesions. They can occur anywhere from the mouth to the anus with a reported incidence of 1 in 18.00 to 1 in 4500 live births. Duodenal duplication cysts represent 2-12% of all duplications. Authors present the case of 5-month-old boy admitted to Pediatric Surgery Department with the symptoms of mechanical obstruction of alimentary tract and gastrointestinal bleeding (melena). US of the abdomen was suggestive of stenosis of pyloric muscle. CT scan provided correct, definite diagnosis of the duplication cyst of the duodenum. The diagnosis was confirmed during surgery and by histopathology examination, which revealed the presence of ectopic pancreatic tissue within the duplication cyst. In the presented case, it was sufficient to excise the duplication cyst alone with the stripping of the mucosal lining. Closed approach allowed for effective relief of obstruction, a rapid postoperative recovery, and the early reinstitution of feeding after 24 h. Duodenal duplication cysts are rare, and some of them can be detected after significant growth with development of compressive symptoms; concern about malignant change makes surgery and complete excision, the preferred method of treatment; because they are unique entities, the surgeon should be familiar with the anatomy and clinical characteristics of these lesions.