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Gastrointestinal Duplication Cysts
A. Carlson Merrow, Jr., MD, FAAP; Sara M. O'Hara, MD, FAAP
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Clinical Issues

          TERMINOLOGY

          • Synonyms

            • Foregut/midgut/hindgut malformation or duplication, enteric cyst, enterocyst, enterocystoma, enterogenous cyst, dorsal enteric cyst, alimentary tract duplication
          • Definitions

            • GI duplication cysts have 3 defining characteristics
              • Well-developed coat of smooth muscle
              • Epithelial lining representing some part of GI tract
              • Attachment to (± communication with) GI tract
                • Ultra rare isolated cysts: No longer attached
              • Neurenteric cysts often have associated vertebral & intraspinal anomalies
                • Most frequent with esophageal duplications

          IMAGING

          • General Features

            • Radiographic Findings

              • Fluoroscopic Findings

                • CT Findings

                  • MR Findings

                    • Ultrasonographic Findings

                      • Nuclear Medicine Findings

                        • Imaging Recommendations

                          DIFFERENTIAL DIAGNOSIS

                            PATHOLOGY

                            • General Features

                              • Gross Pathologic & Surgical Features

                                • Microscopic Features

                                  CLINICAL ISSUES

                                  • Presentation

                                    • Demographics

                                      • Natural History & Prognosis

                                        • Treatment

                                          DIAGNOSTIC CHECKLIST

                                          • Image Interpretation Pearls

                                            Selected References

                                            1. Kumar D et al: Education and imaging. Gastroenterology: revisiting the forgotten sign: five layered gut signature and Y configuration in enteric duplication cysts on high resolution ultrasound. J Gastroenterol Hepatol. 30(7):1111, 2015
                                            2. Kumar K et al: Synchronous thoracic and abdominal enteric duplication cysts: accurate detection with (99m)Tc-pertechnetate scintigraphy. Indian J Nucl Med. 30(1):59-61, 2015
                                            3. Sharma S et al: Enteric duplication cysts in children: a clinicopathological dilemma. J Clin Diagn Res. 9(8):EC08-11, 2015
                                            4. Tritou I et al: The sonographic multilaminar appearance is not enough for the diagnosis of enteric duplication cyst in children. AJR Am J Roentgenol. 204(2):W222-3, 2015
                                            5. Liu R et al: Duplication cysts: diagnosis, management, and the role of endoscopic ultrasound. Endosc Ultrasound. 3(3):152-60, 2014
                                            6. Ben-Ishay O et al: Multiple duplication cysts diagnosed prenatally: case report and review of the literature. Pediatr Surg Int. 29(4):397-400, 2013
                                            7. Knod JL et al: Foregut duplication cyst associated with esophageal atresia and tracheoesophageal fistula: a case report and literature review. J Pediatr Surg. 48(5):E5-7, 2013
                                            8. Lopez-Fernandez S et al: Pyloroduodenal duplication cysts: treatment of 11 cases. Eur J Pediatr Surg. 23(4):312-6, 2013
                                            9. Palacios A et al: Prenatal sonographic findings of duodenal duplication: case report. J Clin Ultrasound. 41(S1):1-5, 2013
                                            10. Dillman JR et al: Ileal dysgenesis coexisting with multiple enteric duplication cysts in a child--MR enterography, CT, and Meckel scan appearances. Pediatr Radiol. 42(12):1517-22, 2012
                                            11. Koffie RM et al: Periampullary duodenal duplication cyst masquerading as a choledochocele. Pediatr Surg Int. 28(10):1035-9, 2012
                                            12. Tang XB et al: An intraluminal pyloric duplication cyst in an infant. J Pediatr Surg. 43(12):2305-7, 2008
                                            13. Cheng G et al: Sonographic pitfalls in the diagnosis of enteric duplication cysts. AJR Am J Roentgenol. 184(2):521-5, 2005
                                            14. Wootton-Gorges SL et al: Giant cystic abdominal masses in children. Pediatr Radiol. 35(12):1277-88, 2005
                                            15. Kong K et al: Foregut duplication cyst arising in the floor of mouth. Int J Pediatr Otorhinolaryngol. 68(6):827-30, 2004
                                            16. Menon P et al: Isolated enteric duplication cysts. J Pediatr Surg. 39(8):e5-7, 2004
                                            17. Tong SC et al: Best cases from the AFIP. Ileocecal enteric duplication cyst: radiologic-pathologic correlation. Radiographics. 22(5):1217-22, 2002
                                            18. Spottswood SE: Peristalsis in duplication cyst: a new diagnostic sonographic finding. Pediatr Radiol. 24(5):344-5, 1994
                                            19. Stoupis C et al: Bubbles in the belly: imaging of cystic mesenteric or omental masses. Radiographics. 14(4):729-37, 1994
                                            Related Anatomy
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                                            Related Differential Diagnoses
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                                            References
                                            Tables

                                            Tables

                                            KEY FACTS

                                            • Terminology

                                              • Imaging

                                                • Top Differential Diagnoses

                                                  • Clinical Issues

                                                    TERMINOLOGY

                                                    • Synonyms

                                                      • Foregut/midgut/hindgut malformation or duplication, enteric cyst, enterocyst, enterocystoma, enterogenous cyst, dorsal enteric cyst, alimentary tract duplication
                                                    • Definitions

                                                      • GI duplication cysts have 3 defining characteristics
                                                        • Well-developed coat of smooth muscle
                                                        • Epithelial lining representing some part of GI tract
                                                        • Attachment to (± communication with) GI tract
                                                          • Ultra rare isolated cysts: No longer attached
                                                        • Neurenteric cysts often have associated vertebral & intraspinal anomalies
                                                          • Most frequent with esophageal duplications

                                                    IMAGING

                                                    • General Features

                                                      • Radiographic Findings

                                                        • Fluoroscopic Findings

                                                          • CT Findings

                                                            • MR Findings

                                                              • Ultrasonographic Findings

                                                                • Nuclear Medicine Findings

                                                                  • Imaging Recommendations

                                                                    DIFFERENTIAL DIAGNOSIS

                                                                      PATHOLOGY

                                                                      • General Features

                                                                        • Gross Pathologic & Surgical Features

                                                                          • Microscopic Features

                                                                            CLINICAL ISSUES

                                                                            • Presentation

                                                                              • Demographics

                                                                                • Natural History & Prognosis

                                                                                  • Treatment

                                                                                    DIAGNOSTIC CHECKLIST

                                                                                    • Image Interpretation Pearls

                                                                                      Selected References

                                                                                      1. Kumar D et al: Education and imaging. Gastroenterology: revisiting the forgotten sign: five layered gut signature and Y configuration in enteric duplication cysts on high resolution ultrasound. J Gastroenterol Hepatol. 30(7):1111, 2015
                                                                                      2. Kumar K et al: Synchronous thoracic and abdominal enteric duplication cysts: accurate detection with (99m)Tc-pertechnetate scintigraphy. Indian J Nucl Med. 30(1):59-61, 2015
                                                                                      3. Sharma S et al: Enteric duplication cysts in children: a clinicopathological dilemma. J Clin Diagn Res. 9(8):EC08-11, 2015
                                                                                      4. Tritou I et al: The sonographic multilaminar appearance is not enough for the diagnosis of enteric duplication cyst in children. AJR Am J Roentgenol. 204(2):W222-3, 2015
                                                                                      5. Liu R et al: Duplication cysts: diagnosis, management, and the role of endoscopic ultrasound. Endosc Ultrasound. 3(3):152-60, 2014
                                                                                      6. Ben-Ishay O et al: Multiple duplication cysts diagnosed prenatally: case report and review of the literature. Pediatr Surg Int. 29(4):397-400, 2013
                                                                                      7. Knod JL et al: Foregut duplication cyst associated with esophageal atresia and tracheoesophageal fistula: a case report and literature review. J Pediatr Surg. 48(5):E5-7, 2013
                                                                                      8. Lopez-Fernandez S et al: Pyloroduodenal duplication cysts: treatment of 11 cases. Eur J Pediatr Surg. 23(4):312-6, 2013
                                                                                      9. Palacios A et al: Prenatal sonographic findings of duodenal duplication: case report. J Clin Ultrasound. 41(S1):1-5, 2013
                                                                                      10. Dillman JR et al: Ileal dysgenesis coexisting with multiple enteric duplication cysts in a child--MR enterography, CT, and Meckel scan appearances. Pediatr Radiol. 42(12):1517-22, 2012
                                                                                      11. Koffie RM et al: Periampullary duodenal duplication cyst masquerading as a choledochocele. Pediatr Surg Int. 28(10):1035-9, 2012
                                                                                      12. Tang XB et al: An intraluminal pyloric duplication cyst in an infant. J Pediatr Surg. 43(12):2305-7, 2008
                                                                                      13. Cheng G et al: Sonographic pitfalls in the diagnosis of enteric duplication cysts. AJR Am J Roentgenol. 184(2):521-5, 2005
                                                                                      14. Wootton-Gorges SL et al: Giant cystic abdominal masses in children. Pediatr Radiol. 35(12):1277-88, 2005
                                                                                      15. Kong K et al: Foregut duplication cyst arising in the floor of mouth. Int J Pediatr Otorhinolaryngol. 68(6):827-30, 2004
                                                                                      16. Menon P et al: Isolated enteric duplication cysts. J Pediatr Surg. 39(8):e5-7, 2004
                                                                                      17. Tong SC et al: Best cases from the AFIP. Ileocecal enteric duplication cyst: radiologic-pathologic correlation. Radiographics. 22(5):1217-22, 2002
                                                                                      18. Spottswood SE: Peristalsis in duplication cyst: a new diagnostic sonographic finding. Pediatr Radiol. 24(5):344-5, 1994
                                                                                      19. Stoupis C et al: Bubbles in the belly: imaging of cystic mesenteric or omental masses. Radiographics. 14(4):729-37, 1994