GASTRIC DUPLICATION CYSTS

Most gastric duplications are cystic and non-communicating found on the greater curvature of the stomach close to the pylorus (1).

ULTRASOUND

• Cystic abdominal mass.
• The wall of the cyst may have an inner hyperechoic layer (mucosa), and a hypoechoic outer layer (muscular layer) (2).
• Usually posterior to the stomach (3), anterior to the spleen and inferior to the left lobe of the liver.
• No relationship to the gallbladder or hepatobiliary system.
• Cyst was constantly seen from 24 weeks gestation even after fetal physiologic gastric emptying (see above case seen in our department).
• Size of the cyst is extremely variable (most are 3-6cm).
• Shape:
• 82% are cystic and noncommunicating.
• 18% are tubular and communicated with the gastric lumen (4).
• Position:
• Majority occurs along the greater curvature of the stomach, with the majority in the antrum.

ASSOCIATIONS

• May be associated with an intraabdominal pulmonary sequestration and cystic adenomatoid malformation (5).
• Duplication of the esophagus (4).
• Vertebral malformations (6).
• Aberrant pancreas (6).

DIFFERENTIAL DIAGNOSIS

• Neuroblastoma.
• Teratoma of the stomach.
• Pancreatic pseudocyst.

REFERENCES

1. Boureau M. Intestinal duplication. In: Navarro J, Schmitz J (eds). Pediatric gastroenterology. New York, Oxford University Press 1992:404-410.
2. Bidwell JK, Nelson A. Prenatal ultrasonographic diagnosis of congenital duplication of the stomach J Ultrasound Med 1986;5:589.
3. Ozmen MN, Onderoglu L, Ciftci AO et.al. Prenatal diagnosis of gastric duplication cyst. J Ultrasound Med 1997;16:219-222.
4. Wieczorek RL, Seiderman I, Ranson JHC et.al. Congenital duplication of the stomach: Review of English literature. Am J Gastroenterol 1984;79:597.
5. Brink DA, Balsara ZN. Prenatal detection of intra-abdominal pulmonary sequestration with postnatal MRI correlation. Pediatr Radiol 1991;21:227-229.
6. Parker BC, Guthrie J, France NE et.al. Gastric duplications in infancy. J Pediatr Surg 1972;7:294.