Management of Intestinal Duplication Cysts

Diagnostic Evaluation

Intestinal duplication cysts are rare congenital anomalies that can occur anywhere along the gastrointestinal tract and are characterized as anechoic, smooth, spherical or tubular structures with well-defined walls on ultrasound 1, 2
When identified on antenatal ultrasound, a detailed obstetrical ultrasound examination should be performed to evaluate for associated anomalies, including comprehensive fetal anatomic survey 3
EUS (endoscopic ultrasound) can confirm the diagnosis by showing an anechoic structure with a well-defined wall that does not communicate with the gastrointestinal lumen 1
If the cystic structure is adjacent to the pancreas, EUS/FNA may be needed to rule out pancreatic pseudocyst or pancreatic cystic neoplasm 2

A third-trimester ultrasound is recommended for reassessment and evaluation of fetal growth 3

Failing to distinguish intestinal duplication cysts from other cystic abdominal masses such as ovarian cysts, mesenteric cysts, or pancreatic pseudocysts can lead to misdiagnosis 1, 2
Missing associated anomalies by not performing a comprehensive fetal anatomic survey can lead to delayed diagnosis of related conditions 3

Pediatric providers should be informed of the antenatal finding at the time of delivery for appropriate postnatal follow-up 4