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    Go to the top of the page   ID: 20070112213053 Original case in english  More links about this topic on Pubmed (PubMed Reader)
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    Noncommunicating small bowel duplication
    Martin Stenzel. Noncommunicating small bowel duplication. PedRad [serial online] vol 7, no. 1.
    URL: www.PedRad.info/?search=20070112213053


     
     Pediatric Radiology CasesImages to this case: There are Ultrasound-images available for this case. [ Ultrasound ] There are Pathology-images available for this case. [ Pathology ] View all modalities [ All ]   
     Pediatric Radiology CasesAuthor/s:

    Martin Stenzel (Institut für Radiologie/Unfallkrankenhaus Berlin-Marzahn/Deutschland)  

     
     Pediatric Radiology CasesEmail Address:

    Viewable for logged on visitors (Log on)  

     
     Pediatric Radiology CasesAge:

    5 Months  

     
     Pediatric Radiology CasesGender:

    Male  

     
     Pediatric Radiology CasesRegion-Organ:

    GI-Small intestine  

     
     Pediatric Radiology CasesMost likely etiology:

    congenital  

     
     Pediatric Radiology CasesHistory:

    5 month old male infant. Acute vomiting several times a day since the second month of life. Physical examination is unremarkable.  

     
     Pediatric Radiology CasesPathomorphology or Pathophysiology of this disease :

    A duplication can occur from the mouth to the anal canal, always in relation to the gastrointestinal tract. Mucosa with secretory glands lead to cystic and tubular appearance.  

     
     Pediatric Radiology CasesRadiological findings:


    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: B mode [Toshiba Aplio 50]:
    5 layered, 35 x 12 mm bowel like structure in the right mid abdomen without evidence of a communication with the small bowel (whole arrows) . There is a small amount of fluid within the lumen. In addition, a 5 mm hypoechoic structure is noted at the outer border of this structure with a thin wall (arrow with interrupted lines).




    Ultrasound 2 <- view Ultrasound 2

    Ultrasound 2: Color coded ultrasound:
    In the color coded US there is evidence of vessels.




    Ultrasound 3 <- view Ultrasound 3

    Ultrasound 3: B mode:
    5 layered, 35 x 12 mm bowel like structure in the right mid abdomen without evidence of a communication with the small bowel (whole arrows) . There is a small amount of fluid within the lumen. Mesenteric lymph nodes (arrow with interrupted lines). Peristalsis could not be observed.




    Pathology 1 <- view Pathology 1

    Pathology 1: Intraoperative/macro-/microscopic findings:
    Structure with vessel stalk, evidence of several mucoceles - consistent with the smaller round structure in the picture - adjacent to the wall. The structure is completely covered with serosa, consistent with a noncommunicating form.
    Macroscopic sample: the arrow shows the vessel stalk with ligation suture.
    [With permission of the Institute of Pathology, Sana Hospitals Lichtenberg]




    Pathology 2 <- view Pathology 2

    Pathology 2: Intraoperative/macro-/microscopic findings:
    Structure with vessel stalk, evidence of several mucoceles - consistent with the smaller round structure in the picture - adjacent to the wall. The structure is completely covered with serosa, consistent with a noncommunicating form.
    Macroscopic sample, opened: a mucocele is marked with an arrow.
    [With permission of the Institute of Pathology, Sana Hospitals Lichtenberg]

     

     
     Pediatric Radiology CasesDiagnosis confirmation:

    Surgery / Histo  

     
     Pediatric Radiology CasesWhich DD would be also possible with the radiological findings:

    Mesenterial cyst, Omental cyst, Meckel's diverticulum  

     
     Pediatric Radiology CasesCourse / Prognosis / Frequency / Other :

    According to IYER 2/3 of the cases become clinical within the first year of life. The symptoms are dependent on the location of the duplication. Duplications may represent origins for intussusceptions. Further complications: hemorrhage, perforation, ileus.
    Multiple isolated duplications have been also described in one child (MENON).
    According to IYER duplications are associated with cardiac anomalie, myelomeningoceles and microcephalus.
    Etiology: vascular insufficiency which leads to separation of small bowel segments in the fetal period?
    Noncommunicating duplications are extremely rare (so far only 4 case reports). As in the case of STEINER there seems to be a resorption of the secreted fluids in the noncommunicating variant.  

     
     Pediatric Radiology CasesComments of the author about the case:

    The duplication was shown on a prior study (not shown) as a cystic structure with a luminal width of 30 mm.  

     
     Pediatric Radiology CasesFirst description / History:

    N/A  

     
     Pediatric Radiology CasesLiterature:

    1. Medline: Medline
    Iyer CP, Mahour GH.
    Duplications of the Alimentary Tract in Infants and Children.
    J Pediatr Surg 1995; 30:1267-70.

    2. Medline: Medline
    Steiner Z, Mogilner J.
    A Rare Case of Completely Isolated Duplication Cyst of the Alimentary Tract.
    J Pediatr Surg 1999; 34:1284-6.

    3. Medline: Medline
    Menon P, Rao KLN, Vaiphei K.
    Isolated Enteric Duplication Cysts.
    J Pediatr Surg 2004;39:E27.  

     
     Pediatric Radiology CasesKeywords:

    infant, acute vomiting, acute emesis, intestinal duplication, cyst, surgery, noncommunicating duplication, small bowel duplication, duplication, noncommunicating, child, childhood, pediatric radiology  

     
     Pediatric Radiology Cases Cite this article:

    Martin Stenzel. Noncommunicating small bowel duplication. PedRad [serial online] vol 7, no. 1.
    URL: www.PedRad.info/?search=20070112213053  

     
     Pediatric Radiology Cases Read similar articles: with corresponding keywords
    in the same field: GI-Small intestine
    or in the region: GI
    or in the tissue/organ: Small intestine
    or with the etiology: congenital
     
     Pediatric Radiology CasesImages to this case: There are Ultrasound-images available for this case. [ Ultrasound ] There are Pathology-images available for this case. [ Pathology ] View all modalities [ All ]   
     
    Noncommunicating small bowel duplication
    Martin Stenzel. Noncommunicating small bowel duplication. PedRad [serial online] vol 7, no. 1.
    URL: www.PedRad.info/?search=20070112213053


     

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    Noncommunicating small bowel duplication
    Other cases by these authors:

    Search Martin Stenzel in Medline Martin Stenzel (1)   

    Noncommunicating small bowel duplication  
     
    Noncommunicating small bowel duplication
    Martin Stenzel. Noncommunicating small bowel duplication. PedRad [serial online] vol 7, no. 1.
    URL: www.PedRad.info/?search=20070112213053


     

    Which diagnosis have other collegues guessed?


    • Mesenterial cyst
      Votes: 2 (16 %)


    • Omental cyst
      Votes: 0 (0 %)


    • Meckel's diverticulum
      Votes: 1 (8 %)


    • Small bowel duplication
      Votes: 8 (66 %)


    • GIST tumor
      Votes: 1 (8 %)



        Total answers: 12

     
    Noncommunicating small bowel duplication
    Martin Stenzel. Noncommunicating small bowel duplication. PedRad [serial online] vol 7, no. 1.
    URL: www.PedRad.info/?search=20070112213053


     

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    Noncommunicating small bowel duplication
    Martin Stenzel. Noncommunicating small bowel duplication. PedRad [serial online] vol 7, no. 1.
    URL: www.PedRad.info/?search=20070112213053


     




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