Enteric duplication cysts pediatric

These comparatively rare lesions present in infancy or early childhood with nausea, gastrointestinal bleeding,
intestinal obstruction and, occasionally, a palpable mass. Most are intra-abdominal but oesophageal
Ultrasound images of Duplication cyst with thickened wall adjacent to bowel.
Ultrasound images  Typical ‘double’ wall seen in enteric duplication cysts.
Abdominal fluid-filled masses in paediatrics—differential diagnoses
Choledochal cyst
Mesenteric cyst
Duplication cyst
Hepatic cyst
Pancreatic pseudocyst
Epidermoid cyst of the spleen
Ovarian cyst
Encysted fluid associated with ventriculoperitoneal shunt tubing
Renal cyst or renal dilatation
Cystic renal tumour duplication cysts cause a thoracic lesion with respiratory symptoms.
 Multiple cysts may be present.
The fluid-filled lesion may demonstrate a spectrum of ultrasonic appearances, from anechoic to hyperechoic, sometimes with gravity-dependent debris or blood. The wall is well defined and a hyperechoic inner rim of mucosa may be identified in some cases of intestinal duplication (Fig. ultrasound images above). The cyst is closely related to the adjacent bowel and this can be appreciated on real-time scanning as the bowel peristalses. CT and MRI rarely add anything to the ultrasound information. Contrast radiography may show an extrinsic defect but communication with the cyst is rare.
There are many causes of intra-abdominal cystic masses in children. The main differential diagnosis in the infant girl is from an ovarian cyst as the ovary is generally an intra-abdominal organ at this age. Useful indicators of an ovarian origin can be detected on careful sonography, by detecting some residual ovarian tissue in the cyst wall, and the finding of a clearly seen multifollicular ovary on one side with absent visualization of a definite ovary on the other side.
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