Choi Ji Eun, Lim Soyeoun, Park Chang Ryul, Cha Hee Jeong, Kwon Woon-Jung
Department of Radiology Thoracic and Cardiovascular Surgery Pathology of Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Republic of Korea.
Medicine (Baltimore). 2017 Dec;96(50):e9184. doi: 10.1097/MD.0000000000009184.
A foregut duplication cyst (FDC) is an uncommon congenital disease. This report presents a case of mediastinal foregut duplication cyst that mimicked a diaphragmatic small bowel hernia.
A 27-month-old girl was first referred for a mediastinal lesion found incidentally on a chest radiograph. At that time, our impression was cystic lung lesion such as congenital pulmonary airway malformation or pulmonary sequestration. At the age 6 years, she presented with recurrent vomiting. The physical examination and laboratory studies were within normal limits.
Chest CT revealed a thin- and smooth-walled cystic mass containing an air-fluid level in the left paravertebral space. It had several inner circular folds and characteristic double-layer enhancement and inner circular fold. Our radiological impression was a type I congenital cystic adenomatoid malformation.
The patients undergone video-assisted thoracoscopic surgery for excision. The operative finding was the cystic mass with smooth bowel-like outer surface and located between the aorta and heart. The cyst was excised and confirmed to be a foregut duplication cyst pathologically.
The patient was doing well with no postoperative complications during follow-up. Recurrent vomiting was improved. This is the first case report describing foregut duplication cyst mimicking a small bowel hernia.
Foregut duplication cysts are rare congenital anomalies of primitive foregut origin. They can occur at any level of the alimentary track and comprise approximately 10% of all mediastinal tumors. Its characteristic double-layered histopathological nature, an FDC can show a double-layered enhancement pattern, which is typical in the alimentary tract.
前肠重复囊肿（FDC）是一种罕见的先天性疾病。本报告介绍了一例纵隔前肠重复囊肿，其表现类似膈小肠疝。
一名27个月大的女孩因胸部X线片偶然发现纵隔病变而首次就诊。当时，我们的印象是囊性肺病变，如先天性肺气道畸形或肺隔离症。6岁时，她出现反复呕吐。体格检查和实验室检查均在正常范围内。
胸部CT显示左椎旁间隙有一个薄壁光滑的囊性肿块，内有气液平面。它有几个内部环形褶皱，具有特征性的双层强化和内部环形褶皱。我们的放射学印象是I型先天性囊性腺瘤样畸形。
患者接受了电视辅助胸腔镜手术切除。手术所见为囊性肿块，外表面光滑，类似肠管，位于主动脉和心脏之间。囊肿被切除，病理证实为前肠重复囊肿。
患者恢复良好，随访期间无术后并发症。反复呕吐症状有所改善。这是首例描述前肠重复囊肿类似小肠疝的病例报告。
前肠重复囊肿是罕见的起源于原始前肠的先天性异常。它们可发生于消化道的任何部位，约占所有纵隔肿瘤的10%。因其具有特征性的双层组织病理学性质，前肠重复囊肿可表现出双层强化模式，这在消化道中很典型。
