School of Medicine (Mr Anderson) and Department of Surgery (Drs Pappas and Perez), Duke University Medical Center, Duke University, Durham, North Carolina, USA.
Department of General and Thoracic Surgery, The Hospital for Sick Children, Toronto, Ontario, Canada (Dr. Rialon).

ABSTRACT

Introduction: Duodenal duplication cysts are rare congenital malformations that are most often identified incidentally and managed nonoperatively. Because of the location of the cyst, it can obstruct the biliopancreatic ampulla requiring operative intervention. An open surgical approach is the conventional procedure for these patients.

Case Descriptions: Since 1990, our institution has resected 3 duodenal duplication cysts. Symptomatic 15- and 17-year-olds underwent open resection of duplication cysts. Most recently, a 25-year-old woman presented with recurring pancreatitis and was subsequently diagnosed with a duodenal cyst on computed tomographic scan and endoscopic ultrasonography. The patient was taken to the operating room for laparoscopic excision. Operative time for the laparoscopic approach was 2 hours and 45 minutes, with no significant intraoperative blood loss. Postoperative recovery was uneventful in all cases.

Discussion: After identification of appropriate operative candidates, laparoscopic resection for duodenal duplication cysts is a feasible procedure that provides smaller incisions and decreased blood loss.

Key Words: Duodenal duplication cyst, Laparoscopic resection, Laparoscopy, Surgical treatment.

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Department of General Surgery, Hospital Italiano de Buenos Aires, Argentina (Drs. Dietrich, Santos). Department of HPB Surgery, Hospital Italiano de Buenos Aires, Argentina (Drs. de Santibañes, Cristiano, Sanchez Clariá). Department of Pathology, Hospital Italiano de Buenos Aires, Argentina (Dr. Santino).

ABSTRACT

Bronchogenic cysts are rare, benign, congenital anomalies of the primitive foregut encountered in the posterior mediastinum. Retroperitoneal location is uncommon, with only a few cases reported in the literature.

We present a 46-year-old man who was examined for a complaint of nonspecific chronic abdominal pain. An abdominal computed tomography scan and magnetic resonance imaging scan were performed and revealed a mass in the peripancreatic region in relation to the left adrenal gland. Because a definitive diagnosis was uncertain, the patient underwent a laparoscopic resection. The pathology showed a cystic lesion consistent with retroperitoneal bronchogenic cyst. The patient had an uneventful postoperative recovery.

Surgical resection of these lesions is mandatory to arrive at a differential diagnosis with other retroperitoneal lesions. The laparoscopic approach should be performed by experienced surgeons.

Key Words: Bronchogenic cysts, Retroperitoneal mass, Laparoscopic resection.

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