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Case Reports: Rare disease
Gastric duplication cyst of a bifid pancreas: cause of recurrent vomiting
  1. Rita Pina-Prata1,2,
  2. Filipa Rosa3,
  3. Inês Fontes4 and
  4. Sofia Morão5
  1. 1Radiology Department, King's College London, Evelina London Children's Hospital, London, UK
  2. 2Radiology Department, Centro Hospitalar Universitário Lisboa Central EPE, Lisbon, Portugal
  3. 3Anatomical Pathology Department, Instituto Português de Oncologia de Lisboa Francisco Gentil EPE, Lisbon, Portugal
  4. 4Paediatric Department, Hospital Dona Estefânia, Centro Hospitalar Universitário Lisboa Central EPE, Lisbon, Portugal
  5. 5Paediatric Surgery Department, Hospital Dona Estefânia, Centro Hospitalar Universitário Lisboa Central EPE, Lisbon, Portugal
  1. Correspondence to Dr Rita Pina-Prata; rprata.radiology{at}gmail.com

Abstract

An infant girl first presented with recurrent episodes of non-bilious vomiting, having had five hospitalisations over the following months because of dehydration. Laboratory data showed no inflammatory response, normal pancreatic amylase, but increased lipase levels (between 67 and 425 U/L). Several abdominal ultrasound studies suggested an intestinal duplication cyst on left hypochondrium and, later, a dilated and irregular pancreatic duct. CT showed a bifid tailed pancreas and a change in the cyst’s characteristics. A communication with the pancreatic duct was hypothesised, which was confirmed on MR cholangiopancreatography. On laparoscopic surgery, the cyst was confirmed to be at the end of the caudal side of the pancreatic bifid tail, having no communication with the stomach. Cystectomy with partial pancreatectomy was performed with pathological findings confirming a gastric duplication cyst originating from the pancreatic bifid tail. At latest follow-up, 4 months after surgery, she remains asymptomatic.

  • Paediatrics
  • Congenital disorders
  • Gastroenterology
  • Pancreas and biliary tract

http://dx.doi.org/10.1136/bcr-2022-254019

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    Footnotes

    • Contributors SM and RPP participated in the study conception or design. SM, RPP, IF and FR participated in acquisition of data. RPP and FR participated in the analysis or interpretation of data. SM and RPP participated in the drafting of the manuscript. SM participated in the critical revision of the manuscript. All authors approved the final manuscript and are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.