Preoperative ultrasound diagnosis of a gastric duplication cyst with ectopic pancreas in a child.

Duplication cysts of the antral and duodenal regions are rare, and small ones are difficult to diagnose preoperatively. The authors present the case of a 4-year-old boy with recurrent bouts of upper gastrointestinal hemorrhage over the previous 2 years. At first, gastroscopy was diagnostic for antral ulcerations, which healed with medical treatment. Chronic blood loss persisted and was associated with abdominal pain. A barium study showed antral deformity, with a suspected mass, which prompted a selective ultrasound examination, during which a 1-cm duplication cyst was detected. Of special interest is the change in shape and content of that cyst, demonstrated sonographically over a 2-month period. In children, high-resolution ultrasonography can be an important step in evaluation of the gastrointestinal tract. Here it showed a small but surgically significant lesion.