Journal of Ultrasound in Medicine, Vol 13, Issue 11 863-870, Copyright © 1994 by American Institute of Ultrasound in Medicine
Ultrasonographic features of gastrointestinal duplications
S. R. Segal, N. H. Sherman, H. K. Rosenberg, C. L. Kirby, P. A. Caro, R. D. Bellah, J. E. Sagerman and M. M. Horrow
Division of Ultrasound, Children's Hospital of Philadelphia, Pennsylvania.
The variable sonographic appearance of duplication cysts is presented.
Eighteen sonograms from 14 patients, aged 1 day to 8 years, were reviewed
over an 8 year period. Water and other aqueous contrast agents were used in
six patients as part of the sonographic evaluation. All lesions were
confirmed by surgery. All but two patients were symptomatic. Twenty-four
cysts were detected, ranging in size from 1.7 to 15.5 cm. The duplication
cysts revealed a spectrum of sonographic findings (cystic to solid
appearing masses). The mass characteristics, including the "muscular rim
sign," and internal debris or hemorrhage, were demonstrated. Multiple
unsuspected cysts (3 of 14 or 20%) and complications such as perforation
were readily seen with ultrasonography. Serial sonograms demonstrated the
changing morphology of two cysts. Other unsuspected intra-abdominal and
pelvic pathologic conditions, including pyloric stenosis and ovarian cysts,
were identified. Identification of the muscular rim sign is the most
reliable indication of a duplication cyst. Multiple masses as well as
possible accompanying anomalies in the abdomen and pelvis are readily
evaluated with sonography. Lesions are easily followed with serial studies
if there is no surgical intervention.
