Esophageal duplications and bronchogenic cysts are aberrations of primitive foregut development. Duplications can be found along the entire length of the esophagus with varying presentation depending on their location and pressure effects on neighboring structures. Although duplications can remain asymptomatic, they may get discovered incidentally during unrelated investigations. The complicated duplications can present with life-threatening symptoms.
Differential diagnosis of posterior mediastinal rounded opacity on radiological investigation should include esophageal duplication cyst. Investigations such as an upper gastrointestinal contrast study and computed tomography of the chest are not diagnostic but can suggest duplication cyst. Once identified and investigated, the duplications should be resected.
Thoracoscopic surgery is recommended for resection of all uncomplicated and some complicated cysts. Thoracoscopic surgery reduces the hospital stay, postoperative analgesia requirement, and morbidity compared to open surgery. Although thoracotomy can achieve resection, it should be reserved for the complicated cysts. The outcome after complete resection is excellent. Surgical complications can be avoided by optical magnification and careful dissection close to the cyst. Incomplete resection results in recurrence. Surgical complications are related to inadvertent accidental injury to the surrounding vessels, nerves, thoracic duct, esophagus, and neighboring trachea. This chapter attempts to give an overview of the esophageal duplication and its current management.
Esophageal duplications Mediastinal cysts Thoracoscopic surgery Neuroenteric cyst
This is a preview of subscription content, log in to check access.
Arbona JL, Fazzi JG, Mayoral J. Congenital esophageal cysts: case report and review of literature. Am J Gastroenterol. 1984;79:177–82.PubMedGoogle Scholar
Beardmore HE, Wiglesworth FW. Vertebral anomalies and alimentary duplications; clinical and embryological aspects. Pediatr Clin N Am. 1958:457–74.CrossRefGoogle Scholar
Benedict LA, Bairdain S, Paulus JK, Jackson CC, Chen C, Kelleher C. Esophageal duplication cysts and closure of the muscle layer. J Surg Res. 2016;206(1):231–4.CrossRefGoogle Scholar
Bratu I, et al. Foregut duplications: is there an advantage to thoracoscopic resection? J Pediatr Surg. 2005;40(1):138–41.CrossRefGoogle Scholar
Chuang MT, Barba FA, Kaneko M, Trirstein AS. Adenocarcinoma arising in an intrathoracic duplication cyst of foregut origin. Cancer. 1981;47:1887.CrossRefGoogle Scholar
Cocker DM, Parikh D, Brown R. Multiple antenatally diagnosed foregut duplication cysts excised and the value of thoracoscopy in diagnosing small concurrent cysts. Ann R Coll Surg Engl. 2006;88(6):8–10.CrossRefGoogle Scholar
Dresler CM, Patterson GA, Taylor BR, Moote DJ. Complete foregut duplication. Ann Thorac Surg. 1990;50:306.CrossRefGoogle Scholar
Rhaney K, Barclay GPT. Enterogenous cysts and congenital diverticula of the alimentary canal with abnormalities of the vertebral column and spinal cord. J Pathol Bacteriol. 1959;77:457.CrossRefGoogle Scholar
Snyder CL, Bickler SW, Gittes GK, Ramachandran V, Ashcraft KW. Esophageal duplication cyst with esophageal Web and tracheoesophageal fistula. J Pediatr Surg. 1996;31(7):968–9.CrossRefGoogle Scholar
Stringer MD, et al. Management of alimentary tract duplication in children. Br J Surg. 1995;82(1):74–8.CrossRefGoogle Scholar
Sundararajan L, Parikh DH. Evolving experience with video-assisted thoracic surgery in congenital cystic lung lesions in a British pediatric center. J Pediatr Surg. 2007;42(7):1243–50.CrossRefGoogle Scholar
Tapia RH, White VA. Squamous cell carcinoma arising in a duplication cyst of the esophagus. Am J Gastroenterol. 1985;80(5):325–9.PubMedGoogle Scholar
Veeneklass GMH. Pathogenesis of intrathoracic gastrogenic cysts. Am J Dis Child. 1952;83:500.Google Scholar