SPR Unknown # 97 -- FINAL

Lee K. Collins, MD

North Shore-LIJ Health System

Division of Radiology


Publication Date: 2013-09-22

History

8 month old boy with history of prematurity and congenital heart disease presents with abdominal distension and increased irritability, which is recurrent.

Findings

The fluoroscopic image shows a smooth indentation of the gastric fundus anteriorly along the greater curvature. There was no contrast leak or enteric communication with the cyst.

The ultrasound images show a thick walled cyst with hyperechoic mucosa consistent with 'gut signature' in the anterior upper abdomen. This communicates with a fluid collection anterior to it.

The T2 weigted MRI images demonstrate a thick walled cyst abutting the greater curvature of the stomach anteriorly. There are also several thin walled cysts within the anterior abdomen.

Diagnosis

Gastric duplication cyst

Discussion

This was a case of a gastric duplication cyst, containing pancreatic tissue. There was communication with a complex fluid collection anterior to the cyst.

Gastric duplication cysts make up less than 4% of the intestinal duplication cysts. They are typically thin walled and cystic and arise from the greater curvature. Because they can contain ectopic tissue such as gastric or pancreatic tissue they may bleed, become inflamed and eventually perforate (as this patient did).

Files

6 images