Diagnosis and Treatment of Gastric Duplication in Neonates-A Case Report and Review of the Literature

Background: Gastric duplication is an extremely rare digestive tract malformation with an incidence rate of approximately 17 cases per million, accounting for 2-8% of all digestive tract duplications. Infants the disease lacks obvious symptoms. The incidence of acute cases rarely reported in the neonatal period. Through a review of this case and the historical literature we have accumulated valuable surgical and clinical experience in the treatment of this acute disease. Case presentation: In this case report, the patient presented with abdominal distension, abdominal pain, fever, vomiting at one week after birth, abnormal abdominal masses were identified by color Doppler ultrasound and X-ray. In order to make a further diagnosis, we performed abdominal puncture on the side of the bed. Through the nature of the peritoneal puncture fluid, we identified the indication of emergency operation in the children. In the operation we found a large amount of brown liquid was identified in the abdominal cavity. A mass was identified in the greater curvature adherent to the transverse colon. That was difficult to separate from the surrounding tissues. The cyst was encased in the greater omentum, and perforation was identified after adhesion separation. The diagnosis of gastric duplication was confirmed by surgery and pathology. Conclusion: Gastric duplication is an extremely rare digestive tract malformation especially in newborns. Not all gastric duplications are accompanied by obvious clinical symptoms and this condition is typically detected upon examinations. Preoperative diagnosis by ultrasound and X-ray and abdominal puncture facilitated urgent treatment in this case. Surgery is an effective treatment for gastric duplication. The wide local resection of the gastric mass and the cysts performed in this case achieved satisfactory results. Abdominal puncture, as an effective auxiliary examination, plays an important role in the management of neonatal acute abdomen. It also reminds the pediatric surgeon that all kinds of methods should be used in the treatment of neonatal acute abdomen to save lives.