Clinical Study Of Enteric Duplication Cysts And Abdominal Cystic Lymphatic Malformations In Children: Role Of Laparoscopy In Their Management.

Abstract

Background:  Enteric duplication cysts and cystic lymphatic malformations  including mesenteric and omental cysts are very rare clinical conditions which need early diagnosis and effective management.

Objectives: The aim of our study was to to study presentation, role of various diagnostic modalities, and use of laparoscopy in management of such patients

 Participants: total of  33 children upto 14 years.  21 enteric duplication cysts and 12 cases of abdominal cystic lymphatic malformations.

Study design: Prospective-Retrospective Observational.

Methods: After detailed history and clinical examination, all the patients underwent various diagnostic investigations.USG was investigation of choice. After confirmation of diagnosis, all the patients were categorised into three groups (i)antenatally detected (ii) incidentally detected and (iii)symptomatic. The data was collected and analysed.

Results: Total of 33  subjects (neonates upto 14 years) with mean age of 2.54 years with the youngest of 11 days and oldest of 13 years, Including 63.6% enteric duplication cysts and 36.4% cases of ACLM. Antenatally 33.3% ,Incidentally 18.2% and symptomatic 48.5% were detected. USG abdomen in 100% cases while in 60.6% CECT abdomen and  in 9.1% MRI abdomen was done. Enteric duplication cysts were most commonly located in ileum (57.1%).  100%  Omental cysts were present in greater omentum. While as mesenteric cysts were mostly in ileal mesentery (72%). Exploratory laparotomy with Resection and Anastomosis remained the treatment of choice

Conclusion: intestinal duplications and CLM are rare anomalies. They can occur anywhere in the gastrointestinal tract. Small bowel is the most common site.. They can be diagnosed by USG, CT Scan and MRI. USG is the best investigation. Treatment of choice is resection of cyst with anastomosis of adjacent bowel segment in most of the cases. Laparoscopy can play an essential role in their management.