Presentation
Epigastric pain with postprandial vomiting.
Patient Data
Well-defined bilobulated abdominal cystic lesion of epigastric location, medial to the gallbladder and lateral to the pancreatic head. It shows an echogenic inner layer (mucosal layer) and a hypoechoic outer layer (muscular layer), most consistent with a gastrointestinal tract duplication cyst.
On the barium meal, this cystic mass appears as a well-defined filling defect obstructing partially the duodenal lumen (1st part) and compressing the duodenal bulb.
Case Discussion
Cystic mass in close contact with the 1st part of the duodenum with an echogenic inner mucosal layer and hypoechoic outer muscular layer on ultrasound and a well-defined filling defect on barium meal, most consistent with a duodenal duplication cyst.
The ultrasound exam plays an important role:
to suggest the diagnosis of a GIT duplication cyst by the combination of an echogenic inner mucosal layer and hypoechoic outer muscular layer
to exclude other differential diagnoses at this age, such as omental cyst, and mesenteric cyst
The barium meal to exclude the possibility of an intraluminal duodenal diverticulum (see also the case: intraluminal duodenal diverticulum).
Unable to process the form. Check for errors and try again.