Pediatr Gastroenterol Hepatol Nutr.  2019 Mar;22(2):189-192. 10.5223/pghn.2019.22.2.189.

Gastric Duplication Cyst Presenting as Massive Gastrointestinal Bleeding

• Youssef A
• Ibrahim A
• AlShehabi
• Omran A
• Sharara AI

• KMID: 2440593
• DOI: http://doi.org/10.5223/pghn.2019.22.2.189

Abstract

Gastric duplication cysts (GDCs) are rare congenital anomalies. Presentation of GDCs varies from an asymptomatic abdominal mass to fulminant or massive gastrointestinal (GI) bleeding. Herein, we describe a case of a GDC in a 10-month-old infant presenting with unexplained massive GI hemorrhage and hematemesis. An abdominal ultrasound was negative, while computerized tomography was, initially, inaccessible. Through a series of repeated esophagogastroduodenoscopies, we documented penetration of the GDC into the gastric cavity that was later confirmed by computerized tomography. The patient was treated successfully with surgical resection.

Keyword

Cyst; Gastrointestinal hemorrhage; Endoscopy; Ulcer; Congenital abnormalities

MeSH Terms

Congenital Abnormalities
Endoscopy
Endoscopy, Digestive System
Gastrointestinal Hemorrhage
Hematemesis
Hemorrhage*
Humans
Infant
Ulcer
Ultrasonography

Figure

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  Fig. 1 Development of the ulcers and the consequent orifice, along with the cyst connection to the pylorus. (A) Intact gastric mucosa. (B) The black arrows point to the ulcers that measure 2×2 cm and 5×5 cm, while the white arrow points to the gastric cardia. (C) The orifice of the cyst. (D) The white arrow points to the pyloric sphincter, while the black arrows point to the cyst opening to the pylorus.

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  Fig. 2 Computerized tomography images. Both thin and thick white arrows point to different ends of the gastric duplication cyst.

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  Fig. 3 (A) The gross appearance of the resected cyst. (B, C) Light microscopy of the gastric duplication cyst exhibiting gastric pyloric mucosa (B, H&E stain ×100; C, H&E stain ×600). H&E: hematoxylin and eosin.

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