Radiodiagnosis, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India.
Pathology, Sanjay Gandhi Post Graduate Institute Of Medical Sciences, Lucknow, Uttar Pradesh, India.
BMJ Case Rep. 2021 Sep 7;14(9):e245333. doi: 10.1136/bcr-2021-245333.
Enteric duplication cysts (EDCs) are congenital malformations of the gastrointestinal tract. EDCs can present as tubular or spherical cystic lesions of the abdomen. The tubular variant of EDC arises as an outpouching from the bowel wall, whereas the spherical variant rarely shows bowel communication. EDCs are known to harbour heterotopic pancreatic parenchyma or gastric mucosa. We present a case of EDC of the ileum (tubular type) with heterotopic gastric mucosa in a 7-year-old child who came with malena and abdominal discomfort. CT revealed focal abnormal dilatation of the ileal loop with polypoidal mucosal thickening. Differential diagnosis of lymphoma, bowel polyps and Meckel's diverticula with gastric heterotopia (GH) were considered. Subsequent surgery followed by histopathology revealed it to be EDC with GH. We discuss this case to familiarise radiologists with the atypical imaging features of EDC, to prevent misdiagnosis and initiate prompt treatment in appropriate clinical settings.
肠重复囊肿(EDC)是胃肠道的先天性畸形。EDC 可表现为腹部管状或球形囊性病变。EDC 的管状变异是从肠壁向外膨出,而球形变异很少显示与肠腔相通。EDC 中已知存在异位胰腺实质或胃黏膜。我们报告一例 7 岁儿童回肠 EDC(管状型)伴异位胃黏膜,其表现为黑便和腹部不适。CT 显示回肠袢局部异常扩张,伴有息肉样黏膜增厚。考虑到淋巴瘤、肠息肉和 Meckel 憩室伴胃异位(GH)的鉴别诊断。随后的手术和组织病理学显示为 EDC 伴 GH。我们讨论这个病例,以使放射科医生熟悉 EDC 的非典型影像学特征,以防止误诊,并在适当的临床环境中及时进行治疗。