Retroperitoenal enterogenous cyst with colonic duplication cyst

1. Retroperitoenal enterogenous cyst with colonic duplication cyst : case report of 9-month-old infant Young Ju Hong, SeonaeRyu, Eun Young Chang and SeokJoo Han Department of Pediatric surgery, Severance Children’s Hospital, Yonsei University College of Medicine, Seoul, Korea Background B B Enterogenous cyst is - rare congenital lesion of endodermal derivation - related to intrauterine volvulus with subsequent ischemia and infarction persistence of intrauterine diverticulum incomplete vacuolization of solid alimentary tract Complete isolated enterogenous cyst - rare variant of enteric duplication cyst Unrecognized , asymptomatic cysts be the site of adenocarcinoma during adult life. Coexistence of a enterogenous cyst with a classic enteric duplication cyst - has been reported only twice earlier in the literature Figure 5 Figure 6 Case • An 9-month-old russian boy presented with chronic constipation and prenatal detected intra-abdominal cystic mass. He gave a history of constipation after starting solid food and a gradual increase in the intra-abdominal mass size past nine months(0.9->8.0 cm). • A simple abdomen film showed gas distended bowel loop in the upper abdomen(Figure 1). • Untrasound showed multilobulated and septated cystic lesion with internal debris in right upper abdomen(Figure 2). Under the impression of retroperitoneal cystic lymphangioma and enteric duplication cyst, the operation was conducted. Operative finding revealed pancreatic origin mass rather than cystic lymphangioma. Gross specimen pictures A. figure 7 : retroperitoneal mass B. figure 8,9,10 : colonic duplication cyst A B A Figure 7 Figure 8 B B Figure 1 Figure 2 • A Computed tomography scan confirmed and retroperitoneal cystic mass but could not comment on the origin. It showed features of a cystic lymphangioma (Figure 3, 4). • On the Barium enema study, bowel caliber change or passage delay were not shown, instead, medial side of cecum was filled with contrast and showed dilated bowel loop. This bowel loop had blind end and was thought to have duplicated bowel loop (Feagure 5,6). A A Figure 9 Figure 10 Histopathology of the A. retroperitoneal cystic mass revealed congenital enterogenous cyst having esophagus, stomach and colonic wall, while the B. duplication cyst adjacent to cecum had heterotopic gastric tissue and partly communicated with colonic wall Figure 3 Conclusion Figure 3 Figure 4 This represents third case in the literature of retroperitoenal enterogenous cyst with enteric duplication cyst. Awareness of varied presentation of enterogenous cysts wound help in appropriate management during surgery without any confusion.