Small bowel duplication cyst in the pediatric population—when to operate?
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In brief
In brief
This retrospective study of 16 pediatric patients examines optimal surgical timing for small bowel duplication cysts. Findings suggest asymptomatic, small duplications detected prenatally can be safely managed expectantly and operated after age one using laparoscopic techniques, while larger or symptomatic cases often require earlier intervention.
- Prenatal diagnosis enables elective surgery around 1 year of age with smaller cyst volumes (13 cm³ vs 135 cm³) compared to symptomatic cases.
- Asymptomatic small bowel duplication cysts can be safely managed expectantly and operated after the first year of age.
- Patients without prenatal diagnosis often present urgently with obstruction, pain, or anemia requiring semi-elective intervention.
- Laparoscopic-assisted resection is feasible in older infants with satisfactory outcomes and average 6-day hospital stay.
- Delaying surgery in asymptomatic cases allows for safer laparoscopic approach while avoiding neonatal operative risks.
Written by the GCMD Library team from the article.
Abstract
Introduction
Aim
The aim of the study is to determine the optimal timing for surgery in patients with small bowel duplications.
Methods
A retrospective cohort study, including all patients younger than 18 years who were diagnosed with small bowel duplications from 2013 until 2024 in a single tertiary medical center, was performed. Patients’ demographics, duplication size and location, pathological results, and clinical outcomes were collected.
Results
Sixteen patients (nine boys, seven girls) underwent laparoscopic-assisted resection of small bowel duplication at an average age of 3 years. A prenatal diagnosis was made in 11 patients, 10 (91%) of whom underwent elective surgery at a median age of 1.3 years. Overall, six patients required semi-elective or urgent surgery due to bowel obstruction, abdominal discomfort, or symptomatic anemia, with most (83%) lacking prenatal evaluation. Elective surgery patients had significantly smaller duplications (13 cm3 vs. 135 cm3). Post-operative recovery was satisfactory in all patients, with an average hospital stay of 6 days.
Conclusion
In conclusion, asymptomatic, small duplication cysts in the small bowel of pediatric patients can be managed expectantly and can be operated after the first year of age. This approach is safe and allows for laparoscopic exploration in older infants, yielding satisfactory outcomes.