Esophageal
Duplication Cysts
Esophageal duplication cysts are rare congenital anomalies, although the
esophagus is the second most common location for duplication in the
gastrointestinal tract after the ileum. The cysts are most frequently located
in the right posterior mediastinum at the level of the distal third of the
esophagus.
The cysts are lined by squamous, columnar, cuboidal,
pseudostratified, or ciliated epithelium. They are covered by two thick muscle
layers that are in contiguity with the muscularis propria. They may occur with
other congenital abnormalities such as esophageal atresia. Duplication may
present with megaesophagus similar to achalasia due to obstruction at the
gastroesophageal junction by the cyst. Rarely, cancer may develop in the cyst.
The
most common presenting symptoms are dysphagia or respiratory symptoms
(particularly in the proximal esophagus) due to esophageal and or
tracheobronchial compression. Imaging is commonly performed through a
combination of techniques, including endoscopy, endoscopic ultrasound
(particularly when the cyst appears solid), computed tomography, and barium
esophagography. The diagnosis can be made in utero, in childhood, or in
adulthood. When found incidentally, no further treatment is needed. For patients
with symptoms or complications, surgical excision is usually indicated.
