Stephanie G Wood, Pawan Chansaenroj, MD, Jonathan Carter, MD, Stanley Rogers. UCSF Medical Center
Gastrointestinal tract duplication cysts are rare congenital gastrointestinal malformations. The majority of these lesions are symptomatic and diagnosed in childhood. Gastric duplication cysts makeup approximately 6% of all intestinal duplication cysts.
This video case presentation describes a 62-year-old female who was diagnosed with both esophageal and gastric enteric duplication cysts incidentally noted on CT scan for an episode of uncomplicated diverticulitis. She was asymptomatic and opted for conservative management and serial imaging. Eight years after her diagnosis, she presented to the emergency department with 10 days of fever, SOB, and progressive dysphagia. A CT scan noted interval enlargement of both cysts. Her symptoms and associated fevers were concerning for worsening mass effect of cysts and possible super-infection. She underwent a right thoracotomy with resection of intra-thoracic esophageal duplication cyst with thoracic surgery. A large duplication cyst extended from just below the thoracic inlet along the extent of the esophagus with a neck of cyst traversing the diaphragm at level of esophageal hiatus. Prior to resection, the cyst was opened and purulent material was drained. A post thoracotomy CT showed persistent gastric duplication cyst with air fluid levels. She then underwent a laparoscopic resection of the gastric duplication cyst with general surgery. The cyst wall was noted to be inseparable from the posterior gastric serosa. The cyst was opened posterolaterally and drained with a suction irrigation catheter prior to resection of its wall. A JP drain was placed and later removed in clinic 1 week later. She developed a recurrent abscess in the same area that required subsequent laparoscopic drainage. She ultimately recovered well. Her drain was removed after 1 month, and she had no further sequela.
This presentation describes a rare case of both esophageal and gastric duplication cysts diagnosed in a middle aged woman, successfully managed with resection.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 80728
Program Number: V085
Presentation Session: Friday Exhibit Hall Video Presentations Session 2 (Non CME)
Presentation Type: EHVideo