ULTRASONOGRAPHIC FEATURES OF GASTROINTESTINAL DUPLICATIONS

The variable sonographic appearance of duplication cysts is presented. Eighteen sonograms from 14 patients, aged 1 day to 8 years, were revi ewed over an 8 year period. Water and other aqueous contrast agents we re used in six patients as part of the sonographic evaluation. All les ions 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 (cy stic to solid appearing masses). The mass characteristics, including t he ''muscular rim sign,'' and internal debris or hemorrhage, were demo nstrated. Multiple unsuspected cysts (3 of 14 or 20%) and complication s such as perforation were readily seen with ultrasonography. Serial s onograms demonstrated the changing morphology of two cysts. Other unsu spected intra-abdominal and pelvic pathologic conditions, including py loric stenosis and ovarian cysts, were identified. Identification of t he muscular rim sign is the most reliable indication of a duplication cyst. Multiple masses as well as possible accompanying anomalies in th e abdomen and pelvis are readily evaluated with sonography. Lesions ar e easily followed with serial studies if there is no surgical interven tion.