Multiple thoracic and abdominal foregut duplication cysts:A case report

BACKGROUND Congenital enteric duplication cysts are tubular or cystic structures that normally lie alongside the gastrointestinal(GI)tract.Enteric duplication cysts are typically solitary lesions that occur anywhere near the GI tract from the neck to the rectum,but having multiple duplication cysts is rare,and presentation within the pancreas is extremely rare.CASE SUMMARY We herein demonstrate a case of esophageal,gastric,and gastric-type duplication cyst of the pancreas in a seventeen-month-old girl who presented with failure to thrive,abdominal pain,vomiting,hematemesis,and melena since the age of three months.The cysts were excised by thoracoscopy and laparoscopy in the same setting.To our knowledge,no such case has been published.CONCLUSION Enteric duplications can occur throughout the entire alimentary tract.When they occur in the pancreas,they present a formidable challenge in both diagnosis and treatment.Due to the risk of complications and malignant transformation,surgical removal is the recommended treatment of all duplication cysts.

Duplication of the Urethra in Boys: A Case Report

Supernumerary urethra in boys is a very rare anatomical entity. Sagittal urethral duplications are classified into four groups: epispadias, hypospadias, fusiform and Y-shaped urethra. The most widely used classification is that of Effmann and Lebowitz, which describes 6 types, one of the rarest being the ‘Y’ subtype IIA2, which corresponds to a duplicated urethral path from the vesical neck to an ectopic perineal or anal outlet. We report here the case of a 4-year-old child presenting with subtype IIA2 with a perineal orifice and no other urinary disorders.

Text duplication of papers in four medical related fields

Purpose:To reveal the typical features of text duplication in papers from four medical fields:basic medicine,health management,pharmacology and pharmacy,and public health and preventive medicine.To analyze the reasons for duplication and provide suggestions for the management of medical academic misconduct.Design/methodology/approach:In total,2,469 representative Chinese journal papers were included in our research,which were submitted by researchers in 2020 and 2021.A plagiarism check was carried out using the Academic Misconduct Literature Check System(AMLC).We generated a corrected similarity index based on the AMLC general similarity index for further analysis.We compared the similarity indices of papers in four medical fields and revealed their trends over time;differences in similarity index between review and research articles were also analyzed according to the different fields.Further analysis of 143 papers suspected of plagiarism was also performed from the perspective of sections containing duplication and according to the field of research.Findings:Papers in the field of pharmacology and pharmacy had the highest similarity index(8.67±5.92%),which was significantly higher than that in other fields,except health management.The similarity index of review articles(9.77±10.28%)was significantly higher than that of research articles(7.41±6.26%).In total,143 papers were suspected of plagiarism(5.80%)with similarity indices≥15%;most were papers on health management(78,54.55%),followed by public health and preventive medicine(38,26.58%);90.21%of the 143 papers had duplication in multiple sections,while only 9.79%had duplication in a single section.The distribution of sections with duplication varied among different fields;papers in pharmacology and pharmacy were more likely to have duplication in the data/methods and introduction/background sections,however,papers in health management were more likely to contain duplication in the introduction/background or results/discussion sections.Different structures for papers in different fields may have caused these differences.Research limitations:There were three limitations to our research.Firstly,we observed that a small number of papers have been checked early.It is unknown who conducted the plagiarism check as this can be included in other evaluations,such as applications for Science and technology projects or awards.If the authors carried out the check,text with high similarity indices may have been excluded before submission,meaning the similarity index in our research may have been lower than the original value.Secondly,there were only four medical fields included in our research.Additional analysis on a wider scale is required in the future.Thirdly,only a general similarity index was calculated in our study;other similarity indices were not tested.Practical implications:A comprehensive analysis of similarity indices in four medical fields was performed.We made several recommendations for the supervision of medical academic misconduct and the formation of criteria for defining suspected plagiarism for medical papers,as well as for the improved accuracy of text duplication checks.Originality/value:We quantified the differences between the AMLC general similarity index and the corrected index,described the situation around text duplication and plagiarism in papers from four medical fields,and revealed differences in similarity indices between different article types.We also revealed differences in the sections containing duplication for papers with suspected plagiarism among different fields.

Cecal duplication cyst in an infant presenting as shock:A case report

BACKGROUND Although intestinal obstruction is one of the most common surgical emergencies in an infant,it is difficult to diagnose neonatal enteric duplication cysts(EDC)preoperatively owing to their rarity as a cause of intestinal obstruction.We describe a case report of a neonatal EDC presenting intestinal obstruction and shock.CASE SUMMARY A 32-d-old male infant with a prenatal sonographic finding of bladder distension was admitted to our hospital for a severely distended abdomen,fever,and oliguria.The first diagnostic hypothesis was septic shock and intestinal obstruction.The patient’s symptoms worsened;following an emergency surgical exploratory laparotomy and histopathological findings,the final diagnosis of cecal duplication cyst was confirmed.The patient’s postoperative course was uneventful,and on the fifth postoperative day,oral feeding restarted.Twenty days later,the patient was discharged from the hospital.CONCLUSION Although EDC located in the cecum is exceptional,it should be considered when evaluating suspected intestinal obstruction and shock.

New treatment for gastric duplication cyst:Endoscopic ultrasonography-guided fine-needle aspiration combined with lauromacrogol sclerotherapy:A case report

BACKGROUND Gastric duplication cysts are very rare disease that are mainly diagnosed by endoscopic ultrasonographic fine-needle aspiration biopsy.In the past,this disease was usually treated with traditional surgery and rarely with minimally invasive endoscopic surgery.However,minimally invasive endoscopic therapy has many advantages,such as no skin wound,organ preservation,postoperative pain reduction,early food intake,fewer postoperative complications,and shorter post-procedure hospitalization.CASE SUMMARY We report a case of endoscopic ultrasonography-guided fine-needle aspiration(EUS-FNA)combined with lauromacrogol sclerotherapy for pyloric obstruction due to gastric duplication cysts.CONCLUSION EUS-FNA combined with lauromacrogol sclerotherapy provides a new option for the treatment of gastrointestinal duplication cysts.

Methyl-CpG-Binding protein 2 duplication syndrome in a Chinese patient:A case report and review of the literature

BACKGROUND Chromosomal Xq28 region duplication encompassing methyl-CpG-binding protein 2(MECP2)results in an identifiable phenotype and global developmental delay known as MECP2 duplication syndrome(MDS).This syndrome has a wide range of clinical manifestations,including abnormalities in appearance,neurodevelopment,and gastrointestinal motility;recurrent infections;and spasticity.Here,we report a case of confirmed MDS at our institution.CASE SUMMARY A 12-year-old Chinese boy presented with intellectual disability(poor intellectual[reasoning,judgment,abstract thinking,and learning]and adaptive[lack of communication and absent social skills,apraxia,and ataxia]functioning)and dysmorphism.He had no history of recurrent infections,seizures,or bowel dysfunction,which is different from that in reported cases.Microarray comparative genomic hybridization confirmed MECP2 duplication in the patient and his mother who is a carrier.The duplication size was the same in the patient and his mother.No prophylactic antibiotic or anti-seizure therapy was offered to the patient or his mother before or after the consultation.CONCLUSION MDS is rare and has various clinical presentations.Clinical suspicion is critical in patients presenting with developmental delays.

Urinary Lithiasis Secondary to Urethral Duplication: A Case Report

Urethral duplication is a rare congenital anomaly, mainly involving boys, although cases in girls have been reported. The majority of duplications of the urethra are asymptomatic and the discovery of this malformation can be done at any age. Diagnosis and determination of its type are based on urethrocystography with mid-void images, which helps to guide the surgical approach. The treatment is not yet well codified and the therapeutic attitude varies from one author to another. We report a clinical observation of a urethral duplication with a calculus in a six-year-old boy who underwent a partial urethrectomy of the supernumerary urethra in whom a lithotomy and a urethrectomy were performed via a suspension approach. This observation illustrates the possibility of urinary stone formation after partial urethrectomy of the supernumerary urethra.

Giant teratoma with isolated intestinal duplication in adult: A case report and review of literature

BACKGROUND A combination of diseases is a rare phenomenon.Their clinical manifestations can vary,and the diagnosis can be challenging.Intestinal duplication is a rare congenital malformation,whereas retroperitoneal teratoma is a tumor in the retroperitoneal space,derived from the remaining embryonic tissue.There are relatively few clinical findings on adult retroperitoneal benign tumors.It is hard to believe that these two rare diseases can happen to the same person.CASE SUMMARY A 19-year-old woman complaining of abdominal pain with nausea and vomiting was admitted.Abdominal computed tomography angiography was suggested for invasive teratoma.Intraoperative exploration revealed that the giant teratoma was connected to an isolated intestinal tract in the retroperitoneum.The postoperative pathological examination revealed that mature giant teratoma was present with intestinal duplication.This was a rare intraoperative finding that was successfully treated surgically.CONCLUSION The clinical manifestations of intestinal duplication malformation are various,and difficult to diagnose before the operation.The possibility of intestinal replication should be considered when intraperitoneal cystic lesions are present.

Evidence-based literature review:De-duplication a cornerstone for quality

Evidence-based literature reviews play a vital role in contemporary research,facilitating the synthesis of knowledge from multiple sources to inform decisionmaking and scientific advancements.Within this framework,de-duplication emerges as a part of the process for ensuring the integrity and reliability of evidence extraction.This opinion review delves into the evolution of de-duplication,highlights its importance in evidence synthesis,explores various de-duplication methods,discusses evolving technologies,and proposes best practices.By addressing ethical considerations this paper emphasizes the significance of deduplication as a cornerstone for quality in evidence-based literature reviews.

Case of Incomplete Ureteral Duplication Complicated with Lithiasis and Right Uretero-Hydronephrosis

Ureteral duplication is congenital malformative uropathy that occurs most often in children. Complete ureteral duplication is defined by a kidney that has two ureters with two orifices that communicate to the bladder through two ureteral meati. It is an anatomical variant that remains rare. Its early discovery is due to a lack of diagnostic means, hence the occurrence of long-term complications. To this end, we observe an increased importance of the morbidity linked to the late diagnosis of this duplicity. We report a case of incomplete ureteral duplication complicated by ureterohydronephrosis on lithiasis wedged in the uretero-vesical junction of one of the ureters in its lower portion which required uretero-lithotomy with bladder reimplantation of the ureters. Our aim was to show the importance of the morbidity associated with late diagnosis of this anomaly and the incidence of infection and complications that this pathology poses as a problem. This was a clinical case of fortuitous discovery managed by a general surgeon in the general surgery department of the hospital “Mère Enfant” Le Luxembourg Bamako Mali. The suites were simple.

Segmental Duplications Are Common in Rice Genome

Segmental duplications on rice (Oryza sativa L.) chromosomes 8, 9, 11, and 12 were studied by examining the distributions of sequences resolved by 13 probes detecting multiple copies of DNA sequences. Four of the hybridization bands detected by a repetitive sequence probe, rTRS, were mapped to the ends of all the four chromosomes. Two or three of the bands detected by each of the other 12 probes were also mapped to different chromosomes. The bands detected by the same probe usually occurred in similar locations of different chromosomes. Loci detected by different DNA probes were often similarly arranged on different chromosomes. Chromosomes 8 and 9 showed colinearity of marker loci arrangement indicating a possible common origin. A segment on chromosome 9 was also very similar to the previously reported duplicated fragments on the ends of chromosomes 11 and 12 which were also detected in this study, indicating a likely common origin. Moreover, the various degrees of distributional similarity of the segments suggest a complex relationship among the chromosomes in the evolution of the rice genome. These results support the proposition that chromosome duplication and diversification may be a mechanism for the origin and evolution of the chromosomes in the rice genome.

A Case Report: High-Grade Urothelial Carcinoma in the Renal Pelvis with Complete Kidney and Ureter Duplication Featuring Heterologous Differentiation

This report describes a considerably rare case of high-grade urothelial carcinoma of the renal pelvis and ureter,presenting with heterologous differentiation,in a patient with bilateral duplicated kidneys.A 73-year-old male experienced intermittent gross hematuria for 5 months,accompanied by lower back and abdominal pain.Ultrasound and computed tomography scans revealed bilateral renal and ureteral duplication with multiple tumors in the left renal pelvis.A total nephroterectomy and bladder cuff resection were performed on the left two nephrons.Multiple space-occupying lesions were identified in the left renal pelvis and ureter.Histopathological examination showed poorly differentiated and diverse tumor cells,manifesting as sarcomatoid carcinoma,papillary adenocarcinoma,and infiltrating high-grade urothelial carcinoma.The tumor infiltrated the subcutaneous fibrous connective tissue of the renal pelvis and the full thickness of the ureter.Given the rarity of recurrent renal urothelial carcinoma with heterogeneous differentiation,comprehensive imaging and pathological assessments are vital to delineate the nature of the lesion and the direction of tissue pathological heterologous differentiation.These evaluations guide early radical surgical interventions,improving survival rates.

Total colorectal and terminal ileal duplication presenting as intussusception and intestinal obstruction

Colonic intussusception and gastrointestinal duplication are diseases that arise in young children. The clinical presentation of adult cases of intussusception and enteric duplication is non-specific and thus poses a diagnostic challenge. A computed tomography (CT) scan is recommended in adult cases as the most sensitive diagnostic tool and the pathognomonic finding of outer intussuscepiens and central intussusceptum is diagnostic. A septum of a duplicated colon in a non-intussuscepted segment has been rarely reported in the literature. With advancements in radiological imaging technology and the increased availability of CT scanners, the capacity for a correct pre-operative diagnosis has been significantly enhanced. Our current case report illustrates the importance of considering an uncommon etiology for enteric intussusception and duplication as a differential diagnosis of acute abdomen in an adult patient. Our analyses of this patient also highlight the successful use of CT scanning to make this diagnosis.

Alimentary tract duplications in newborns and children: Diagnostic aspects and the role of laparoscopic treatment

Alimentary tract duplications are rare congenital lesions normally diagnosed in newborns and children that can occur anywhere from the mouth to the anus and have a reported incidence of approximately 1 in 4500 life births. Symptoms and clinical presentation vary greatly. The presentation varies according to age and location. The treatment finally is surgical; total resection when possible should be the aim of the intervention. In pediatric surgery minimally invasive surgical procedures became more and more important over the last decades. In consequence the operative procedure on alimentary tract duplications changed in this manner. We review on case reports and clinical reports on minimally invasive surgery in the treatment of alimentary tract duplications, determine the importance of minimally invasive techniques in the treatment of this rare entity and rule out that further studies in the field should be performed.

The impact of tandem duplication on gene evolution in Solanaceae species

Whole genome duplication(WGD) and tandem duplication(TD) are important modes of gene amplification and functional innovation, and they are common in plant genome evolution. We analyzed the genomes of three Solanaceae species(Solanum lycopersicum, Capsicum annuum, and Petunia inflata), which share a common distant ancestor with Vitis vinifera, Theobroma cacao, and Coffea canephora but have undergone an extra whole genome triplication(WGT) event. The analysis was used to investigate the phenomenon of tandem gene evolution with(S. lycopersicum) or without WGT(V. vinifera). Among the tandem gene arrays in these genomes, we found that V. vinifera, which has not experienced the WGT event, retained relatively more and larger tandem duplicated gene(TDG) clusters than the Solanaceae species that experienced the WGT event. Larger TDG clusters tend to be derived from older TD events, so this indicates that continuous TDGs(absolute dosage) accumulated during long-term evolution. In addition, WGD and TD show a significant bias in the functional categories of the genes retained. WGD tends to retain dose-sensitive genes related to biological processes, including DNA-binding and transcription factor activity, while TD tends to retain genes involved in stress resistance. WGD and TD also provide more possibilities for gene functional innovation through gene fusion and fission. The TDG cluster containing the tomato fusarium wilt resistance gene I3 contains 15 genes, and one of these genes, Solyc07g055560, has undergone a fusion event after the duplication events. These data provide evidence that helps explain the new functionalization of TDGs in adapting to environmental changes.

Combined duplication of the colon and vermiform appendix in an adult patient

Combined duplication of the colon and vermiform appendix is one of the rare congenital anomalities of the alimentary tract. Only a few cases have been reported in the adult population. A 28-year-old man presented to the clinic with a mass in the right flank. Imaging showed only a hydronephrotic atrophic kidney. The f inal diagnosis was only available at exploration. Combined duplication of the tubular colon and vermiform appendix was conf irmed histopathologically. The patient was treated with nephrectomy and complete resection of the duplicated colon and vermiform appendix. The patient recovered uneventfully,and has done well for the past year. This is believed to be one of the first reports of combined duplication of the tubular colon and vermiform appendix as a cause of hydronephrotic atrophic kidney in an adult patient.

Endoscopic treatment of periampullary duodenal duplication cysts in children: Four case reports and review of the literature

BACKGROUND Duodenal duplications are rare congenital anomalies of the gastrointestinal tract.As the periampullary variant is much rarer,literature is scant and only few authors have reported their experience in diagnosis and treatment,particularly with operative endoscopy.CASE SUMARY To report our experience with the endoscopic treatment in a series of children with periampullary duodenal duplication cysts,focusing on the importance of obtaining an accurate preoperative anatomic assessment of the malformations.The pediatric periampullary duodenal duplication cyst literature is reviewed.We conducted a systematic review according to the PRISMA guidelines.The PubMed database was searched for original studies on“duodenal duplication”,“periampullary duplication”or“endoscopic management”published since 1990,involving patients younger than 18 years of age.Eligible study designs were case report,case series and reviews.We analyzed the data and reported the results in table and text.Fifteen eligible articles met the inclusion criteria with 16 patients,and analysis was extended to our additional 4 cases.Median age at diagnosis was 13.5 years.Endoscopic treatment was performed in 10(50%)patients,with only 2 registered complications.CONCLUSION Periampullary duodenal duplication cysts in pediatric patients are very rare.Our experience suggests that an accurate preoperative assessment is critical.In the presence of sludge or stones inside the duplication,endoscopic retrograde cholangio-pancreatography is mandatory to demonstrate a communication with the biliary tree.Endoscopic treatment resulted in a safe,minimally invasive and effective treatment.In periampullary duodenal duplication cyst endoscopically treated children,long-term follow-up is still necessary considering the potential malignant transformation at the duplication site.

Rare adult gastric duplication cyst mimicking a gastrointestinal stromal tumor

Gastric duplication cyst is a very rare gastrointestinal tract malformation that accounts for 2%-4%of alimentary tract duplications.Most cases are diagnosed within the first year of life,following presentation of abdominal pain,vomiting,and weight loss and clinical discovery of an abdominal palpable mass.This case report describes a very uncommon symptomatic gastric duplication cyst diagnosed for the first time in adulthood.Only a few other case reports of similar condition exist,and all were identified by endosonography.The current case involves a 52-year-old male who presented with a onemonth history of progressive iron deficiency anemia without overt gastrointestinal bleeding.The patient underwent esophagogastroduodenoscopy,which revealed a 2.0 cm pinkish subepithelial lesion,suspected to be a gastrointestinal stromal tumor(GIST)and source of gastrointestinal bleeding.The endosonography showed inhomogeneous hypoechoic lesions with focal anechoic areas arising from a second and third layer of the gastric wall.Differential diagnoses of GIST,neuroendocrine tumor,or pancreatic heterotopia were made.The lesion was removed using an endoscopic submucosal resection technique.Histopathology revealed an erosive gastric mass composed of a complex structure of dilated gastric glands surrounded by fibro-muscular tissue,fibroblasts,and smooth muscle bundles,which led to the diagnosis of gastric duplication.

Foregut duplication cysts of the stomach with respiratory epithelium

Gastrointestinal duplication is a congenital rare disease entity. Gastric duplication cysts seem to appear even more rarely. Herein, two duplications cysts of the stomach in a 46 year-old female patient are presented. Abdominal computed tomography demonstrated a cystic lesion attached to the posterior aspect of the gastric fundus, while upper gastrointestinal endoscopy was negative. An exploratory laparotomy revealed a non-communicating cyst and a smaller similar cyst embedded in the gastrosplenic ligament. Excision of both cysts along with the spleen was performed and pathology reported two smooth muscle coated cysts with a pseudostratified ciliated epithelial lining (respiratory type).

Partial intestinal obstruction secondary to multiple lipomas within jejunal duplication cyst: A case report

Lipoma within jejunal duplication presenting as abdominal bloating and partial intestinal obstruction is an exceptional clinical entity.We report a case of 68-year-old man complaining of abdominal bloating for 10 d due to multiple lipomas arising from jejunal duplication cysts.Only a few cases of a single lipoma within a Meckel’s diverticulum giving rise to this clinical scenario have been reported in the English language literature.However,no case of multiple lipomas within jejunal duplication cysts has been reported.We present a case in which doubleballoon endoscopy revealed a small intestinal structure changed into Meckel’s diverticulum-like cavities containing several lipomas.This case highlights intestinal lipoma as an uncommon cause of adult intussusceptions,which should be included in the differential diagnosis of small intestinal obstruction and appropriate examinations should be chosen.