Endoscopic treatment of periampullary duodenal duplication cysts in children: Four case reports and review of the literature

Anna Lavinia Bulotta; Maria Vittoria Stern; Dario Moneghini; Filippo Parolini; Maria Pia Bondioni; Guido Missale; Giovanni Boroni; Daniele Alberti

doi:10.4253/wjge.v13.i10.529

Endoscopic treatment of periampullary duodenal duplication cysts in children: Four case reports and review of the literature

World J Gastrointest Endosc. 2021 Oct 16;13(10):529-542. doi: 10.4253/wjge.v13.i10.529.

Authors

Anna Lavinia Bulotta¹, Maria Vittoria Stern¹, Dario Moneghini², Filippo Parolini³, Maria Pia Bondioni⁴, Guido Missale², Giovanni Boroni¹, Daniele Alberti¹

Affiliations

¹ Department of Pediatric Surgery, Azienda Socio Sanitaria Territoriale degli Spedali Civili di Brescia, Brescia 25123, Italy.
² Department of Digestive Endoscopy, Azienda Socio Sanitaria Territoriale degli Spedali Civili di Brescia, Brescia 25123, Italy.
³ Department of Pediatric Surgery, Azienda Socio Sanitaria Territoriale degli Spedali Civili di Brescia, Brescia 25123, Italy. parfil@hotmail.it.
⁴ Department of Pediatric Radiology, Azienda Socio Sanitaria Territoriale degli Spedali Civili di Brescia, Brescia 25123, Italy.

Abstract

Background: Duodenal duplications are rare congenital anomalies of the gastrointestinal tract. As the periampullary variant is much rarer, literature is scant and only few authors have reported their experience in diagnosis and treatment, particularly with operative endoscopy.

Case sumary: To report our experience with the endoscopic treatment in a series of children with periampullary duodenal duplication cysts, focusing on the importance of obtaining an accurate preoperative anatomic assessment of the malformations. The pediatric periampullary duodenal duplication cyst literature is reviewed. We conducted a systematic review according to the PRISMA guidelines. The PubMed database was searched for original studies on "duodenal duplication", "periampullary duplication" or "endoscopic management" published since 1990, involving patients younger than 18 years of age. Eligible study designs were case report, case series and reviews. We analyzed the data and reported the results in table and text. Fifteen eligible articles met the inclusion criteria with 16 patients, and analysis was extended to our additional 4 cases. Median age at diagnosis was 13.5 years. Endoscopic treatment was performed in 10 (50%) patients, with only 2 registered complications.

Conclusion: Periampullary duodenal duplication cysts in pediatric patients are very rare. Our experience suggests that an accurate preoperative assessment is critical. In the presence of sludge or stones inside the duplication, endoscopic retrograde cholangio-pancreatography is mandatory to demonstrate a communication with the biliary tree. Endoscopic treatment resulted in a safe, minimally invasive and effective treatment. In periampullary duodenal duplication cyst endoscopically treated children, long-term follow-up is still necessary considering the potential malignant transformation at the duplication site.

Keywords: Case report; Double wall sign; Duodenal duplication; Endoscopic treatment; Endoscopic ultrasound; Periampullary duodenal duplication cyst.

Publication types

Case Reports