Duodenal duplication cyst causing massive bleeding in an adult: an unusual complication of a duplication cyst of the digestive tract.

Duodenal duplication cysts are rare malformations that characteristically manifest with intestinal obstruction. In a 50-year experience, we found a duodenal duplication cyst in only three patients, one of whom had massive gastrointestinal bleeding as the initial symptom. Six other duplication cysts (two esophageal, one jejunal, and three ileal) were found. All patients who had extraduodenal intestinal cysts were neonates or infants who initially had an abdominal mass or obstruction. Of the two patients with an esophageal cyst, one had odynophagia and the other had respiratory obstruction. Unusual features of our series of patients were male preponderance (eight of nine patients), the low incidence of other developmental abnormalities, and, in the patients with the duodenal cysts, an age of 14 years or older at the time of onset of symptoms and diagnosis. In an adult, a duodenal duplication cyst may cause upper gastrointestinal hemorrhage. This cause of gastrointestinal bleeding should be considered in the differential diagnosis if an intramural duodenal mass is detected within the medial wall of the second portion of the duodenum distal to the papilla of Vater.