Advertisement

Enteric duplication in children

  • Joseph A. Sujka
  • Justin Sobrino
  • Leo A. Benedict
  • Hanna Alemayehu
  • Shawn St. Peter
  • Richard Hendrickson
Original Article
  • 11 Downloads

Abstract

Introduction

Enteric duplication is a congenital anomaly with varied clinical presentation that requires surgical resection for definitive treatment. This had been approached with laparotomy for resection, but has changed with minimally invasive technique. The purpose of our study was to determine the demographics, natural history, operative interventions, and outcomes of pediatric enteric duplication cysts in a contemporary cohort.

Methods

With IRB approval, we performed a retrospective chart review of all patients less than 18 years old treated for enteric duplication between January 2006 and August 2016. Demographics, patient presentation, operative technique, intraoperative findings, hospital course, and follow-up were evaluated. Descriptive statistical analysis was performed; all medians were reported with interquartile range (IQR).

Results

Thirty-five patients underwent surgery for enteric duplication, with a median age at surgery of 7 months (2.5–54). Median weight was 7.2 kg (6–20). Most common patient presentations included prenatal diagnosis 37% (n = 13). Thirty-four patients (97%) had their cyst approached via minimally invasive technique (thoracoscopy or laparoscopy) with only three (8%) requiring conversion to an open operation. Median operative time was 85 min (54–133) with 27 (77%) patients requiring bowel resection. Median length of bowel resected was 4.5 cm (3–7). Most common site of duplication was ileocecal (n = 15, 42%). Postoperative median hospital length of stay was 3 days (2–5) and median number of days to regular diet was 3 (1–4). No patients required re-operation during their hospital stay. Median follow-up was 25 days (20–38).

Conclusion

In our series, most enteric duplication cysts were diagnosed prenatally. These can be managed via minimally invasive technique with minimal short-term complications, even in neonates and infants.

Keywords

Enteric duplication Laparotomy Bowel resection 

Notes

Author contribution

Joseph Sujka: concept and design, data collection, data analysis and interpretation, drafting article, critical revision of article, approval of article, and statistics. Justin Sobrino: data collection, data analysis and interpretation, and drafting article. Leo A. Benedict: drafting article, critical revision of article, and statistics. Hanna Alemayehu: concept and design, data collection, data analysis and interpretation, drafting article, critical revision of article, approval of article, and statistics. Shawn D. St. Peter: concept and design, data collection, data analysis and interpretation, drafting article, critical revision of article, approval of article, and statistics. Richard J. Hendrickson: concept and design, data collection, data analysis and interpretation, drafting article, critical revision of article, and approval of article.

Funding

No funding was received to conduct this study.

Compliance with ethical standards

Conflict of interest

The authors have no conflict of interest to disclose.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed consent

Informed consent was waived by our IRB due to the fact that the data collected for this study were retrospective and de-identified.

References

  1. 1.
    Patiño Mayer J, Bettolli M (2014) Alimentary tract duplications in newborns and children: diagnostic aspects and the role of laparoscopic treatment. World J Gastroenterol 20:14263–14271.  https://doi.org/10.3748/wjg.v20.i39.14263 CrossRefPubMedPubMedCentralGoogle Scholar
  2. 2.
    Guérin F, Podevin G, Petit T et al (2012) Outcome of alimentary tract duplications operated on by minimally invasive surgery: a retrospective multicenter study by the GECI (Groupe d’Etude en Coeliochirurgie Infantile). Surg Endosc 26:2848–2855.  https://doi.org/10.1007/s00464-012-2259-7 CrossRefPubMedGoogle Scholar
  3. 3.
    Lima M, Molinaro F, Ruggeri G et al (2012) Role of mini-invasive surgery in the treatment of enteric duplications in paediatric age: a survey of 15 years. Pediatr Med E Chir Med Surg Pediatr 34:217–222.  https://doi.org/10.4081/pmc.2012.57 CrossRefGoogle Scholar
  4. 4.
    Górecki W, Bogusz B, Zając A, Sołtysiak P (2015) Laparoscopic and laparoscopy-assisted resection of enteric duplication cysts in children. J Laparoendosc Adv Surg Tech A 25:838–840.  https://doi.org/10.1089/lap.2015.0103 CrossRefPubMedGoogle Scholar
  5. 5.
    Bhat NA, Agarwala S, Mitra DK, Bhatnagar V (2001) Duplications of the alimentary tract in children. Trop Gastroenterol Off J Dig Dis Found 22:33–35Google Scholar
  6. 6.
    Karnak I, Ocal T, Senocak ME et al (2000) Alimentary tract duplications in children: report of 26 years’ experience. Turk J Pediatr 42:118–125PubMedGoogle Scholar
  7. 7.
    Erginel B, Soysal FG, Ozbey H et al (2017) Enteric duplication cysts in children: a single-institution series with forty patients in twenty-six years. World J Surg 41:620–624.  https://doi.org/10.1007/s00268-016-3742-4 CrossRefPubMedGoogle Scholar
  8. 8.
    Kumar K, Dhull VS, Karunanithi S et al (2015) Synchronous thoracic and abdominal enteric duplication cysts: accurate detection with (99 m)Tc-pertechnetate scintigraphy. Indian J Nucl Med IJNM Off J Soc Nucl Med India 30:59–61.  https://doi.org/10.4103/0972-3919.147545 CrossRefGoogle Scholar
  9. 9.
    Segal SR, Sherman NH, Rosenberg HK et al (1994) Ultrasonographic features of gastrointestinal duplications. J Ultrasound Med Off J Am Inst Ultrasound Med 13:863–870CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Joseph A. Sujka
    • 1
  • Justin Sobrino
    • 1
  • Leo A. Benedict
    • 1
  • Hanna Alemayehu
    • 1
  • Shawn St. Peter
    • 1
  • Richard Hendrickson
    • 1
  1. 1.Department of SurgeryChildren’s Mercy HospitalKansasUSA

Personalised recommendations