Clinical characteristics, diagnosis and treatment of duodenal duplication

Objective To explore the clinical characteristics, diagnosis and treatment of duodenal duplication. Methods From May 1, 2007 to May 1, 2018, 4 surgical children were diagnosed pathologically as duodenal duplication.With complete follow-up data, their managements and prognosis were analyzed.There were 2 boys and 2 girls with an age range from 1 month to 9 years.The clinical symptoms included vomiting (n=4), abdominal pain (n=2), abdominal mass (n=2) and ultrasonic finding of abdominal mass (n=1). Ultrasound revealed cystic mass in right upper quadrant (n=4). Cystic wall had the characteristics of intestinal wall and even peristalsis was noticed (n=1). Computed tomography (CT) and upper gastroenterography indicated tissue compressing around cyst.All of them had cystic duodenal duplication.One case was misdiagnosed as pancreatic pseudocyst and underwent external drainage.And subsequent severe abdominal adhesion required cystic mucous stripping.The other 3 patients underwent total cyst removal. Results Pathological examination revealed intestinal mucosa (n=4) and ectopic pancreas (n=2). During follow-ups, 4 children recovered well and there was no occurrence of vomiting, abdominal pain or pancreatitis. Conclusions Duodenal duplication is rare and its clinical manifestations are correlated with size, location, ectopic mucosa and communication with intestinal cavity or pancreatic bile tract.Diagnosis is mainly based upon pathology.Total removal of duplication or mucous stripping has an excellent prognosis.Endoscopic marsupialization should be coupled with mucous stripping for malignant transformation. Key words: Duodenum, abnormalities; Diagnosis; Treatment