Laparoscopic excision of a very rare isolated gastric enteric duplication cyst: case report and literature review

Background
Gastric duplication cysts are a very rare variant of all enteric duplications, and their isolated forms are much rarer developmental anomalies in the form of case reports only. In this study, a 4-month-old male patient, who was diagnosed with an intra-abdominal cystic mass in his antenatal examination and laparoscopic excision of the isolated gastric duplication was presented.
Case presentation
A 4-month-old male patient was born at 39 weeks of gestation, 3180 g. When a 37 × 17mm intra-abdominal cystic mass was detected in the detailed ultrasonography (USG) performed at the 20th week of his antenatal examination, he was followed up in another center with the preliminary diagnosis of mesenteric cyst and intestinal duplication cyst. It was learned that the patient had transient constipation and vomiting in his history. Physical examination revealed a mobile, smooth-surfaced 5-cm mass on palpation in the lower midline of the abdomen. Control ultrasonography revealed a lobulated contoured cystic lesion measuring 59 × 30 × 23 mm, with a multilayered wall structure and debris inside. In laparoscopy, the mass is mobile, thick-walled, cystic in appearance, isolated from surrounding tissues. It was observed that it was attached to the sigmoid colon mesentery with a handle. The thick peduncle containing the feeding vessels was closed and cut, preserving the mesentery. Thick mucoid cyst contents were aspirated with a percutaneous needle. The shrinking cyst was removed from the abdomen by enlarging the working opening of 5 mm. The macroscopic appearance was consistent with intestinal duplication cyst. The patient was fed orally at the 2nd hour postoperatively and was discharged at the 10th hour. In the pathological examination, gastric duplication cyst was diagnosed due to the type of gastric lining epithelium. No recurrence or additional pathology was detected in the control ultrasonography in the 6-month follow-up postoperatively.
Conclusion
Laparoscopic exploration should be considered as the first surgical option in asymptomatic, growing intra-abdominal cystic masses with a preliminary diagnosis of duplication cysts. The advantages of laparoscopy can make important contributions to patient management.