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Pyloric Duplication in Ten Years Old Girl: A Case Report

Received: 10 October 2020     Accepted: 26 October 2020     Published: 9 November 2020
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Abstract

Gastrointestinal duplication cysts are rare congenital anomalies. Pyloric duplication represents 2.2% of all gastrointestinal tract duplications. The presentations merely depend on the site of occurrence, size and type of the cyst, and presence of ectopic mucosal lining. A ten years old girl vomited for two months, accompanied with stomach ache and difficulty in defecation. The color of stool sometimes was black. The body weight decreased twelve kilograms in two months. On physical examination, no abdominal distention and no palpable mass was found, bowel sound was decreased and there was tenderness in epigastric area. Nutritional status of patient was severe malnutrition. Laboratory test revealed mild hypochromic microcytic anemia, severe hyponatremia, severe hypokalemia, and hypoalbuminemia. Abdominal ultrasound revealed thickening of the gastric wall and upper gastrointestinal contrast study revealed partial stenosis with thickening of pyloric wall. Esophagogastroduodenoscopy revealed multiple gastric ulcers and gastric outlet obstruction. Cyst duplication and stricture in the pylorus were found during surgical procedure. The pediatric surgeon performed an excision of duplication cyst and gastroduodenostomy side to side anastomosis. Histopathologic examination from cyst confirmed the enteric duplication cyst. The patient was discharged in good condition. We concluded that pyloric duplication is considered as one of the differential diagnosis in children with symptoms of gastric outlet obstruction. Appropriate surgical procedures should be undertaken to avoid complications.

Published in American Journal of Pediatrics (Volume 6, Issue 4)
DOI 10.11648/j.ajp.20200604.21
Page(s) 455-458
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2020. Published by Science Publishing Group

Keywords

Pediatric, Gastrointestinal Duplication Cyst, Pylorus

References
[1] Sharma S, Yadav AK, Mandal AK, Zaheer S, Yadav DK, Samie A. Enteric duplication cysts in children: a clinicopathological dilemma. JCDR. 2015; 9: 8-11.
[2] Cavar S, Bogovic M, Leutic T, Antabak A, Batinica S. Intestinal duplications - experience in 6 cases. Eur Surg Res. 2006; 38: 329-32.
[3] Murty TV, Bhargava RK, Rakas FS. Gastroduodenal duplications. J Pediatr Surg. 1992; 27: 515-7.
[4] Tanaka H, Masumoto K, Sasaki T, Sakamoto N, Gotoh C, Urita Y, et al. Hypergastrinemia and a duodenal ulcer caused by gastric duplication. Surg Case Rep. 2016; 2: 75.
[5] Cunningham S, Hansel D, Fishman E, Cameron J. Foregut duplication cyst of the stomach. J Gastrointest Surg. 2006; 10: 620-1.
[6] Olajide ARL, Yisau AA, Abdulraseed NA, Kashim IOO, Olaniyi AJ, Morohunfade AOA. Gastrointestinal duplications: experience in seven children and a review of the literature. Saudi J Gastroenterol. 2010; 16 (2): 105-9.
[7] Srikanth KP, Thapa BR, Lal SB, Menon P, Sodhi K, Vaiphei K, et al. Noncommunicating gastric antral duplication cyst presenting with hematemesis due to large antral ulcer. Trop Gastroenterol. 2015; 36: 134-6.
[8] Surridge CA, Goodier MD. Gastric duplication cyst: a cause of rectal bleeding in a young child. Afr J Paediatr Surg. 2014; 11: 267-8.
[9] Liu R, Adler DG. Duplication cysts: diagnosis, management, and role of endoscopic ultrasound. Eusjournal. 2014; 3: 152-8.
[10] Mayer JP, Bettoli M. Alimentary tract duplications in newborns and children: diagnostic aspects and the role of laparoscopic treatment. World J Gastroenterol. 2014; 20: 14263-71.
[11] Marginean CO, Marginean C, Horvath E, Gozar L, Gozar HG. Antenatally diagnosed congenital pyloric duplication associated with intraluminal pyloric cyst - rare entity case report and review of the literature. Rom J Morphol Embryol. 2014; 55 (3): 983-8.
[12] Saad DF, Gow KW, Shehata B, Wulkan ML. Pyloric duplication in a term newborn. J Pediatr Surg. 2005; 40 (7): 1209-10.
[13] Shah A, More B, Buick R. Pyloric duplication in a neonate: a rare entity. Pediatr Surg Int. 2005; 21 (3): 220-2.
[14] Ahmed YB, Ghorbel S, Charieg A, Nouira F, Khemekhem R, Jlidi S, et al. Pyloric duplication: about two cases. Pediatr Neonatal Care J. 2015; 2 (2): 00065.
[15] Ladd WE. Duplications of the alimentary tract. South Med J. 1937; 30: 363-71.
[16] Rasool N, Safdar CA, Ahmad A, Kanwal S. Enteric duplication in children: clinical presentation and outcome. Singapore Med J. 2013; 54: 343-6.
[17] Jehangir S, Ninan PJ, Jacob TJ, Eapen A, Mathai J, Thomas RJ, et al. Enteric duplication in children: experience from a tertiary center in South India. J Indian Assoc Pediatr Surg. 2015; 20: 174-8.
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  • APA Style

    Ni Made Reditya Noviyani, Ni Nyoman Metriani Nesa, I Gusti Ngurah Sanjaya Putra, I Putu Gede Karyana, Kadek Deddy Ariyanta, et al. (2020). Pyloric Duplication in Ten Years Old Girl: A Case Report. American Journal of Pediatrics, 6(4), 455-458. https://doi.org/10.11648/j.ajp.20200604.21

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    ACS Style

    Ni Made Reditya Noviyani; Ni Nyoman Metriani Nesa; I Gusti Ngurah Sanjaya Putra; I Putu Gede Karyana; Kadek Deddy Ariyanta, et al. Pyloric Duplication in Ten Years Old Girl: A Case Report. Am. J. Pediatr. 2020, 6(4), 455-458. doi: 10.11648/j.ajp.20200604.21

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    AMA Style

    Ni Made Reditya Noviyani, Ni Nyoman Metriani Nesa, I Gusti Ngurah Sanjaya Putra, I Putu Gede Karyana, Kadek Deddy Ariyanta, et al. Pyloric Duplication in Ten Years Old Girl: A Case Report. Am J Pediatr. 2020;6(4):455-458. doi: 10.11648/j.ajp.20200604.21

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  • @article{10.11648/j.ajp.20200604.21,
      author = {Ni Made Reditya Noviyani and Ni Nyoman Metriani Nesa and I Gusti Ngurah Sanjaya Putra and I Putu Gede Karyana and Kadek Deddy Ariyanta and I Made Darmajaya and Pande Putu Yuli Anandasari and Ni Wayan Winarti},
      title = {Pyloric Duplication in Ten Years Old Girl: A Case Report},
      journal = {American Journal of Pediatrics},
      volume = {6},
      number = {4},
      pages = {455-458},
      doi = {10.11648/j.ajp.20200604.21},
      url = {https://doi.org/10.11648/j.ajp.20200604.21},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajp.20200604.21},
      abstract = {Gastrointestinal duplication cysts are rare congenital anomalies. Pyloric duplication represents 2.2% of all gastrointestinal tract duplications. The presentations merely depend on the site of occurrence, size and type of the cyst, and presence of ectopic mucosal lining. A ten years old girl vomited for two months, accompanied with stomach ache and difficulty in defecation. The color of stool sometimes was black. The body weight decreased twelve kilograms in two months. On physical examination, no abdominal distention and no palpable mass was found, bowel sound was decreased and there was tenderness in epigastric area. Nutritional status of patient was severe malnutrition. Laboratory test revealed mild hypochromic microcytic anemia, severe hyponatremia, severe hypokalemia, and hypoalbuminemia. Abdominal ultrasound revealed thickening of the gastric wall and upper gastrointestinal contrast study revealed partial stenosis with thickening of pyloric wall. Esophagogastroduodenoscopy revealed multiple gastric ulcers and gastric outlet obstruction. Cyst duplication and stricture in the pylorus were found during surgical procedure. The pediatric surgeon performed an excision of duplication cyst and gastroduodenostomy side to side anastomosis. Histopathologic examination from cyst confirmed the enteric duplication cyst. The patient was discharged in good condition. We concluded that pyloric duplication is considered as one of the differential diagnosis in children with symptoms of gastric outlet obstruction. Appropriate surgical procedures should be undertaken to avoid complications.},
     year = {2020}
    }
    

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  • TY  - JOUR
    T1  - Pyloric Duplication in Ten Years Old Girl: A Case Report
    AU  - Ni Made Reditya Noviyani
    AU  - Ni Nyoman Metriani Nesa
    AU  - I Gusti Ngurah Sanjaya Putra
    AU  - I Putu Gede Karyana
    AU  - Kadek Deddy Ariyanta
    AU  - I Made Darmajaya
    AU  - Pande Putu Yuli Anandasari
    AU  - Ni Wayan Winarti
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    PY  - 2020
    N1  - https://doi.org/10.11648/j.ajp.20200604.21
    DO  - 10.11648/j.ajp.20200604.21
    T2  - American Journal of Pediatrics
    JF  - American Journal of Pediatrics
    JO  - American Journal of Pediatrics
    SP  - 455
    EP  - 458
    PB  - Science Publishing Group
    SN  - 2472-0909
    UR  - https://doi.org/10.11648/j.ajp.20200604.21
    AB  - Gastrointestinal duplication cysts are rare congenital anomalies. Pyloric duplication represents 2.2% of all gastrointestinal tract duplications. The presentations merely depend on the site of occurrence, size and type of the cyst, and presence of ectopic mucosal lining. A ten years old girl vomited for two months, accompanied with stomach ache and difficulty in defecation. The color of stool sometimes was black. The body weight decreased twelve kilograms in two months. On physical examination, no abdominal distention and no palpable mass was found, bowel sound was decreased and there was tenderness in epigastric area. Nutritional status of patient was severe malnutrition. Laboratory test revealed mild hypochromic microcytic anemia, severe hyponatremia, severe hypokalemia, and hypoalbuminemia. Abdominal ultrasound revealed thickening of the gastric wall and upper gastrointestinal contrast study revealed partial stenosis with thickening of pyloric wall. Esophagogastroduodenoscopy revealed multiple gastric ulcers and gastric outlet obstruction. Cyst duplication and stricture in the pylorus were found during surgical procedure. The pediatric surgeon performed an excision of duplication cyst and gastroduodenostomy side to side anastomosis. Histopathologic examination from cyst confirmed the enteric duplication cyst. The patient was discharged in good condition. We concluded that pyloric duplication is considered as one of the differential diagnosis in children with symptoms of gastric outlet obstruction. Appropriate surgical procedures should be undertaken to avoid complications.
    VL  - 6
    IS  - 4
    ER  - 

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Author Information
  • Department of Child Health, Faculty of Medicine, Udayana University/Sanglah Hospital, Denpasar, Indonesia

  • Department of Child Health, Faculty of Medicine, Udayana University/Sanglah Hospital, Denpasar, Indonesia

  • Department of Child Health, Faculty of Medicine, Udayana University/Sanglah Hospital, Denpasar, Indonesia

  • Department of Child Health, Faculty of Medicine, Udayana University/Sanglah Hospital, Denpasar, Indonesia

  • Department of Surgery, Faculty of Medicine, Udayana University/Sanglah Hospital, Denpasar, Indonesia

  • Department of Surgery, Faculty of Medicine, Udayana University/Sanglah Hospital, Denpasar, Indonesia

  • Department of Radiology, Faculty of Medicine, Udayana University/Sanglah Hospital, Denpasar, Indonesia

  • Department of Anatomical Pathology, Faculty of Medicine, Udayana University/Sanglah Hospital, Denpasar, Indonesia

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