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Description
Enteric duplication cysts are rare congenital malformations, most often occurring in pediatric populations with an incidence of 1 in 4,500-10,000 live births. Pancreatic duplication cysts are an even rarer form of enteric duplication cysts. Presenting symptoms are nonspecific abdominal pain, nausea, melena or pancreatitis. Initial imaging is typically ultrasound, CT, or MRI, which often misidentify these as pancreatic neoplasms or pancreatic pseudocysts. The current standard of treatment for pancreatic duplication cysts is surgical excision.
An otherwise healthy 8-year-old female presented with three days of right-sided abdominal pain and diarrhea. CT scan showed a 5 cm bilobed lesion, located medial to the ascending colon, with thickened bowel wall inferiorly and thin peripheral enhancement superiorly. Laboratory findings, including complete blood count and lipase, were within normal limits. On physical exam, there was mild pain localized over the right mid-abdomen. The leading differential diagnosis was perforated Meckel's diverticulitis or inflamed enteric duplication cyst. Treatment consisted of antibiotics for 14 days. After completion of the antibiotic course, the patient returned with fevers, melena, and continued abdominal pain. Repeat CT scan showed near resolution of the previously identified lesion with continued surrounding inflammation. Due to persistent symptoms and concern for recurrence, the decision was made to proceed to the operating room for a diagnostic laparoscopy.
Pancreatic duplication cysts are rare and difficult to diagnose. This particular case was unique since preoperative work-up did not suggest pancreatic origin of the lesion, but rather favored an intestinal source. Due to the unknown natural progression or malignant potential of untreated pancreatic duplication cysts, surgical intervention for imaging findings that are concerning for enteric duplication cysts should be pursued when symptomatic, recurrent, or complicated. Further research on the best diagnostic imaging modality and surgical removal is warranted.
Publication Date
5-8-2026
Disciplines
Surgery
Recommended Citation
Swider-Ebels A, Hawes K, Pennington E. Unexpected pancreatic duplication cyst. Presented at: Research Day Corewell Health West; 2026 May 8; Grand Rapids, MI.
Comments
2026 Research Day Corewell Health West, Grand Rapids, MI, May 8, 2026. Abstract 2065