J Korean Med Sci.  2004 Aug;19(4):604-607. 10.3346/jkms.2004.19.4.604.

Duodenal Duplicated Cyst Manifested by Acute Pancreatitis and Obstructive Jaundice in an Elderly Man

Affiliations
  • 1Department of Internal Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea. gicolon@unitel.co.kr
  • 2Department of Pathology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea.
  • 3Department of Surgery, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea.
  • 4Department of Internal Medicine, Kyung Hee University College of Medicine, Seoul, Korea.

Abstract

A duodenal duplication cyst is an uncommon congenital anomaly that is usually encountered during infancy or in early childhood. Duodenal duplication cysts generally appear on the first or second portion of the duodenum and may cause duodenal obstruction, hemorrhage or pancreatitis. Here, we report a case of a duodenal duplication cyst on the second and third portion of the duodenum in an old aged man with obstructive jaundice and acute pancreatitis, which was treated successfully by a surgical excision.

Keyword

Abnormalities; Duplication Cyst; Duodenum; Pancreatitis; Acute Necrotizing; Jaundice; Obstructive

MeSH Terms

Abnormalities
Aged
*Cysts/complications/diagnosis/pathology
*Duodenal Diseases/complications/diagnosis/pathology
Humans
Jaundice, Obstructive/*etiology
Male
Pancreatitis/*etiology

Figure

  • Fig. 1 Duodenoscopic finding. A huge extrinsic mass causing a luminal obstruction in the proximal second portion of the duodenum, with an intact mucosa.

  • Fig. 2 Computerized tomographic finding. A cystic lesion with a distinct wall in the second-to-third portion of the duodenum (A, B) is shown. The duodenum (closed arrow) is compressed by the cystic lesion and is displaced to the medial side of the lesion (open arrow) (A).

  • Fig. 3 Computerized tomographic finding. Dilated intrahepatic duct (A) and a common bile duct and markedly distended the gallbladder (B) is shown.

  • Fig. 4 Gross finding of the surgical specimen. Segments of the duodenum, duplication cyst, gallbladder and some portions of the pancreas are shown. Resection along the left margin of the cyst (arrow) (A) reveals the inner side of the cystic wall (B). A Kelly is protruding into the duodenum (B).

  • Fig. 5 Microscopic finding of the cyst wall obtained from the septum of the duplicated segment. Mucosal denudation and replacement by granulation tissue are seen. The cyst shares a common muscular layer with the duodenum (bottom) (H&E stain, ×100).


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