Pediatrics & Neonatology
Volume 50, Issue 4 , Pages 169-172, August 2009

Treatment of Duodenal Duplication by Trans-umbilical Exploratory Minimal Laparotomy

  • Li-Lan Chiang

      Affiliations

    • Department of Pediatrics, National Taiwan University Hospital and National Taiwan University College of Medicine, Taiwan
    • ,
  • Wu-Hsun Hsieh

      Affiliations

    • Department of Pediatrics, National Taiwan University Hospital and National Taiwan University College of Medicine, Taiwan
    • ,
  • Jin-Chung Shih

      Affiliations

    • Department of Obstetrics and Gynecology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taiwan
    • ,
  • Wen-Ming Hsu

      Affiliations

    • Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taiwan
    • Corresponding Author InformationCorresponding author. Department of Surgery, National Taiwan University Hospital, 7 Chung-Shan South Road, Taipei 100, Taiwan

Received 9 October 2008; received in revised form 22 December 2008; accepted 6 January 2009.

Article Outline

Duodenal duplication cysts are rare congenital lesions. Their presentation is often non-specific and physical examination and laboratory studies usually reveal no abnormal findings. The diagnosis of duodenal duplication cysts can thus be challenging and relies on ultrasonography, barium swallow, contrast enhanced computed tomography (CT), magnetic resonance imaging (MRI), and magnetic resonance cholangiopancreatography (MRCP). The management of duodenal duplication cyst is surgical. Laparotomy is usually necessary, and complete resection is the management goal. Subtotal excision with stripping of the mucosa due to close involvement of the pancreatobiliary tree, and endoscopic resection have Duodenal duplication cysts are rare congenital lesions usually diagnosed in infancy, although they may present in adulthood. Prenatal diagnosis is difficult, and postnatal diagnosis relies on ultrasonography, barium swallow, contrast-enhanced computerized tomography, magnetic resonance imaging (MRI), and magnetic resonance cholangiopancreatography. A female newborn was diagnosed with an abdominal cyst (size around 6 ×; 5 × 4 cm) at gestational age (GA) 24 weeks, by regular prenatal examination. After her birth at GA 37 weeks, we performed abdominal ultrasonography and MRI, but there was no definite diagnosis. The usual management of an abdominal cyst involves resection by laparotomy (requiring a large incision) or laparoscopy (requiring several small incisions). We performed an exploratory trans-umbilical minimal laparotomy excision for surgery, and the pathology revealed duodenal duplication. In our case, there was no recurrence of the cyst after 18 months follow-up, and the operation scar was almost undetectable. Trans-umbilical minimal laparotomy excision may be considered as an alternative choice for the management of abdominal and duodenal duplication cysts.

Key Words:  duodenal duplication , minimal laparotomy , trans-umbilical , treatment

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References 

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PII: S1875-9572(09)60057-7

doi:10.1016/S1875-9572(09)60057-7

Pediatrics & Neonatology
Volume 50, Issue 4 , Pages 169-172, August 2009

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