Laparoscopic resection of rare foregut duplication cyst lined by pseudostratified columnar epithelium in a pediatric patient

Abstract

Foregut duplications cysts are relatively uncommon in the abdomen with symptoms first presenting during adolescence. The case of a 14-year-old presenting with upper abdominal pain and discomfort detected an abdominal cyst mass (26 × 24 × 32 mm) in the area of the left liver lobe and the anterior wall of the stomach on ultrasound examination. Magnetic resonance imaging (MRI), magnetic resonance cholangiopancreatography (MRCP) and upper gastrointestinal (UGI) contrast studies were performed to localize and establish organ involvement. Laparoscopy was performed to visualize the cystic mass which was located at the level of the esopghageal gastric junction on the lesser curvature of the stomach. The cyst was resected form the stomach wall with the aid of Ligasure^™ (Medtronic Ltd, Watford, UK), however, left a muscle defect on the stomach as it shared the musculature. The muscle defect was over sown with 2–0 non-resorbable braided suture to prevent possible future diverticula formation. The patient recovered well from surgery and histology confirmed the presence of a foregut duplication cyst with lined by pseudostratified columnar epithelium and with the cyst wall containing smooth muscle.