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EDITOR’S QUIZ: GI SNAPSHOT

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Computed tomography of the abdomen revealed a well defined rounded area of fluid collection anterior to the pancreatic uncus and two rounded calcified masses in the duodenal region (fig 2). Endoscopic sonography demonstrated an anechoic double walled cystic lesion adjacent to the pancreas. Based on radiological findings, a diagnosis of duodenal duplication cysts was considered and exploratory surgery was performed. At surgery, separation of the mass from the pancreas was difficult. Histopathological examination confirmed duodenal duplication cyst and found two other cysts containing enteroliths. Enteroliths were previously described in the natural history of duodenal duplication in adults. Intestinal duplication cysts are uncommon congenital anomalies and usually presents during the firsts decade of life. The majority of duplication cysts are tubular or spherical without any communication with the gastrointestinal tract. Duplication cysts of the duodenum are very rare, accounting for only 4–5% of intestinal duplications. Endoscopic sonography is useful, demonstrating anechoic mass surrounded by a double layer intestinal wall.

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