Purpose: The purpose of this study was to evaluate the experience of various institutions with enteric duplication cysts in 215 children during the last 25 years and to demonstrate the variability of their presentations and focus the attention to adopt the more correct and timely treatment.
Materials and Methods: We retrospectively reviewed in the literature the case series of GTD reported in the last 25 years, from 1990 to 2015, and analyzed the prevalence of sex, the duplication site, morphology, clinical presentations, surgical treatment, complications, and the associated anomalies.
Results: Two hundred and fifteen patients, with two hundred twenty duplications, were included in the series. There was a predominance of boys (115 males, 52%; 88 females, 40%; 12 sex not reported, 8%). The distribution of alimentary tract duplications has showed that the most common location is in the midgut (more than 64%), followed by foregut (25.45%) and by hindgut (10.45%). Prevalence of the cystic forms over the tubular ones (80% vs. 14%; 6% not described). The observed clinical presentation was different: respiratory distress, cyanosis, retrosternal pain, and a mass effect for the thoracic forms; nausea, vomiting, obstruction, hemorrhage, or perforation in the gastrointestinal duplications. With regard to treatment, surgical removal/enucleation was the treatment of choice in most symptomatic cases. In asymptomatic patients, surgical treatment should be performed to avoid complications such as ulcers or perforations or neoplastic degeneration, although some authors preferred conservative attitudes and clinical-instrumental monitoring.
Conclusion: Intra-abdominal enteric duplications can cause complications; in children with a diagnosis of acute abdomen, enteric duplication cysts should be considered and also the patients should be further investigated for additional urogenital, gastrointestinal, spinal cord, and vertebral anomalies that could condition diagnosis and timely surgical treatment.
Gatrointestinal tract duplications Congenital anomalies Bowel duplications Enteric cysts Lead point Rare cause of obstruction Cases of malignancies in pediatric age IEDCs Perforations or neoplastic degeneration of enteric cysts
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