TITLE

ADULTS WITH FOREGUT DUPLICATION CYSTS DIAGNOSED BY ENDOSOCPIC ULTRASOUND (EUS) CAN BE SAFELY MANAGED WITH AN EXPECTANT POLICY

AUTHOR(S)
Langmead, L.; James, S.; Norton, I.D.; Jones, D.B.
PUB. DATE
April 2003
SOURCE
Gut;Apr2003 Supplement 1, Vol. 52, pA77
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Background: Enteric duplication cysts (EDC) are rare congenital anomalies that lie within or adjacent to the wall of the gastrointestinal tract. The majority oF EDC have characteristic sonographic patterns on EUS. Because the management for adults diagnosed with foregut EDC at EUS is controversial, we aimed to assess their long term outcome. Methods: We reviewed the indications and EUS findings for patients diagnosed with EDC over 5 years. Outcome was established from medical records and/or a questionnaire sent to referring physicians. Results: Of 768 EUS examinations, 27 patients (10 males) were diagnosed with probable EDC. Median age was 51 years (range, 21-77). Presenting symptoms included dysphagia (n = 7), dyspepsia (6), reflux symptoms (5), and chest pain (2). Abnormal upper Gl endoscopy (n: 21), with possible extrinsic compression (10) or submucosal tumour (8), was the commonest indication for EUS. Other prior investigations were CT (n = 7), barium meal (2), MRI (1) CXR (1), abdominal US (1). At EUS, most EDC were in the oesophagus (proximal (n = 4), mid (7), distal (11)). Other sites were proximal stomach (2) and duodenum (3). Maximal diameter ranged from 10-60 mm. Septation was seen in 2 cysts, sediment in 3, and probable haemorrhage in 4. Follow up data were available in 21 of 27, with diagnosis of EDC subsequently revised in 5/21.3 patients had surgery after further imaging. In a patient with early oesophageal cancer, coincident EDC was not confirmed. A leiomyoma and a bronchial inclusion cyst were found in the others. CT after EUS suggested an alternative diagnosis in 2 patients (1 leiomyoma and 1 partial situs invertus with anomalies of azygous vasculature). In 16 patients (including 4 in whom follow up imaging supported the initial diagnosis oF EDC) an expectant policy was employed. All 16 patients remain well 6 months to 4 years after EUS without development of new symptoms or complications related to the EDC. Conclusion: Adult patients with...
ACCESSION #
9747801

 

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