Duodenal Duplication

  • Etiology: Abnormal budding of gastrointestinal tract lined with gastrointestinal epithelium which may communicate with enteric lumen proper
  • Imaging US: Cystic lesion with echogenic rim sign = enteric signature (gut signature) = hyperechoic inner layer of cyst representing bowel mucosa
  • DDX: Ovarian cyst, mesenteric cyst, omental cyst
  • Complications: May cause obstruction, intussusception, bleeding, volvulus
  • Treatment: Elective surgical removal
  • Clinical:

Radiology Cases of Duodenal Duplication

UGI of duodenal duplication
3 lateral images from an UGI show persistent narrowing of the second portion of the duodenum caused by a round extrinsic mass.
US of duodenal duplication cyst
AXR AP (above left) and AXR left lateral decubitus (below left) show a midline abdominal mass displacing the bowel inferiorly and to the left side of the abdomen. Transverse (above right) and sagittal (below right) US of the abdomen show a complex cystic mass in a subhepatic location. There was no suggestion of a hyperechoic inner layer of the cystic mass.

Surgery Cases of Duodenal Duplication

Surgical image of duodenal duplication
Surgical image shows a cystic mass attached to the inner surface of the C-loop of the duodenum from just distal to the pylorus to slightly proximal to the region of the ampulla of Vater. The distal antrum is visible in the upper left corner of the incision and the gall bladder is visible in the right corner of the incision between the liver and the mass.
Surgical image of duodenal duplication
Surgical image shows a mass attached to the inner surface of the C-loop of the duodenum from just distal to the pylorus to slightly proximal to the region of the ampulla of Vater with the transverse colon draped underneath it.

Gross Pathology Cases of Duodenal Duplication

Gross pathology image of duodenal duplication
Gross pathological image shows an intact cystic mass that had been attached to the inner surface of the C-loop of the duodenum. Two orifices to the duodenal lumen can be seen along the inferior edge of the specimen.

Histopathology Cases of Duodenal Duplication

Histopathology image of duodenal duplication
Histopathological image of H&E stained section shows the duplication at the gastroduodenal junction to be characterized by normal distal gastric antrum mucosa on one (right) side, normal muscularis propria in the middle, and the lining of the duplication cyst of the other (left) side; the mucosa is enteric type with scattered gastric type glands.