Abstract
Lower gastrointestinal bleeding (LGIB) in infants and children is a difficult diagnostic problem largely due to limitations of small-bowel evaluation. Duplication cysts are rare congenital malformations with variable clinical presentation. This report describes seven children (five boys, two girls and median age 10 [1.5–124] months) with ileal duplication cysts who presented with LGIB of varying severity from stool occult blood positivity with anemia to fresh bleeding per rectum. Diagnosis was made by Tc99m pertechnetate scan (n-5), balloon enteroscopy (n-1), and at laparotomy (n-1). Ultrasonography and barium meal follow-through missed the diagnosis in six and three cases, respectively. All cases underwent surgery with resection of the duplication cyst and complete removal of the mucosa containing ectopic gastric tissue while preserving adequate bowel length. A good postoperative outcome with complete symptom resolution was seen in all. Enteric duplication cyst should always be considered in children presenting with occult or overt lower gastrointestinal hemorrhage, and Tc99m pertechnetate scan should be done prior to invasive tests like balloon enteroscopy.
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SP, AS, RL, SKY and UP confirm that they have no conflict of interest to declare.
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The authors declare that the study was performed in a manner to conform with the Helsinki Declaration of 1975, as revised in 2000 and 2008 concerning Human and Animal Rights.
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Pandey, S., Srivastava, A., Lal, R. et al. Enteric duplication cysts in children: A target in algorithm for evaluation of lower gastrointestinal bleeding. Indian J Gastroenterol 33, 285–288 (2014). https://doi.org/10.1007/s12664-014-0445-3
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DOI: https://doi.org/10.1007/s12664-014-0445-3