VideoGIE : an official video journal of the American Society for Gastrointestinal Endoscopy · 2025
Endoscopic ultrasound-guided duodenojejunostomy for a duodenal duplication cyst presenting with duodenal obstruction.
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Nie Shuang, Wang Lei, Shen Shanshan
Аннотация
BACKGROUND AND AIMS: Duodenal duplications are rare congenital anomalies that can cause gastrointestinal obstruction. Although surgical resection is the standard treatment, endoscopic alternatives are increasingly being explored. Endoscopic ultrasound (EUS)-guided anastomosis techniques have shown promise in treating gastrointestinal obstructions. However, their application in cases of duodenal duplication with obstruction remains technically challenging. We present a case where EUS-guided duodenojejunostomy (EUS-DJ) successfully resolved the duodenal obstruction caused by a duodenal duplication.
METHODS: A 50-year-old woman with refractory vomiting and severe electrolyte imbalance was diagnosed with a cystic-communicating duodenal duplication causing duodenal obstruction. As the patient declined surgical intervention, we performed an EUS-DJ. Under EUS guidance, a 19-gauge needle was used to puncture the jejunum via the duodenal cavity, followed by placement of a 15 × 10-mm lumen-apposing metal stent to establish a duodenojejunal bypass.
RESULTS: The patient resumed oral intake by postoperative day 3 and was discharged on day 5. One-month imaging confirmed stent patency and resolution of fluid accumulation. She remained symptom-free at 3-month follow-up.
CONCLUSIONS: EUS-DJ appears to be a feasible and effective minimally invasive option for managing symptomatic duodenal duplication cysts, particularly in patients who are poor surgical candidates or decline surgery.
METHODS: A 50-year-old woman with refractory vomiting and severe electrolyte imbalance was diagnosed with a cystic-communicating duodenal duplication causing duodenal obstruction. As the patient declined surgical intervention, we performed an EUS-DJ. Under EUS guidance, a 19-gauge needle was used to puncture the jejunum via the duodenal cavity, followed by placement of a 15 × 10-mm lumen-apposing metal stent to establish a duodenojejunal bypass.
RESULTS: The patient resumed oral intake by postoperative day 3 and was discharged on day 5. One-month imaging confirmed stent patency and resolution of fluid accumulation. She remained symptom-free at 3-month follow-up.
CONCLUSIONS: EUS-DJ appears to be a feasible and effective minimally invasive option for managing symptomatic duodenal duplication cysts, particularly in patients who are poor surgical candidates or decline surgery.