Fetal enteric duplication cysts are enteric duplication cysts presenting in utero.
They result from an abnormal recanalization of the gastrointestinal tract. They comprise of a two-layer smooth muscle wall and an internal epithelium of a respiratory or intestinal type. These cysts may or may not communicate with the lumen of the gastrointestinal tract. They can be cystic or tubular (with the latter more likely to communicate with the gastrointestinal tract).
They can occur anywhere along the gastrointestinal tract although a greater predilection towards the ileal region (~40%) 3.
They are associated with additional abnormalities in up to a third of the cases. These are most commonly vertebral anomalies 3.
Usually seen as an anechoic cystic lesion within the abdomen that is separate from normal hollow structures such as the bladder and stomach.
Relatively characteristic signs that have been described include 1:
- double wall sign: may not always be present
- gut signature sign: may not always be present
Occasionally they can also present as an echogenic mass 3 (probably due to hemorrhage).
If there is a complicating bowel obstruction, there may be evidence of polyhydramnios.
Treatment and prognosis
Recognized complications include:
- in utero bowel obstruction, sometimes with associated perforation
Considerations on ultrasound for an anechoic mass include:
- 1. Cheng G, Soboleski D, Daneman A et-al. Sonographic pitfalls in the diagnosis of enteric duplication cysts. AJR Am J Roentgenol. 2005;184 (2): 521-5. AJR Am J Roentgenol (full text) - Pubmed citation
- 2. Richards DS, Langham MR, Anderson CD. The prenatal sonographic appearance of enteric duplication cysts. Ultrasound Obstet Gynecol. 1996;7 (1): 17-20. doi:10.1046/j.1469-0705.1996.07010017.x - Pubmed citation
- 3. Mcnamara A, Levine D. Intraabdominal fetal echogenic masses: a practical guide to diagnosis and management. Radiographics. 25 (3): 633-45. doi:10.1148/rg.253045124 - Pubmed citation
- 4. Segal SR, Sherman NH, Rosenberg HK et-al. Ultrasonographic features of gastrointestinal duplications. J Ultrasound Med. 1994;13 (11): 863-70. J Ultrasound Med (abstract) - Pubmed citation
- 5. Chen M, Lam YH, Lin CL et-al. Sonographic features of ileal duplication cyst at 12 weeks. Prenat. Diagn. 2002;22 (12): 1067-70. doi:10.1002/pd.468 - Pubmed citation