DUPLICATION CYST OF THE GASTRIC ANTRUM AS A CAUSE OF ACUTE DISORDER OF GASTRIC-EMPTYING IN AN ADULT

History and clinical findings: A 35-year-old woman without previous hi story of gastrointestinal complaints developed increasing upper abdomi nal pain with nausea and postprandial vomiting over 2 days during whic h she had been unable to take any food. She had no fever; her general physical condition was slightly reduced. While her abdomen felt soft o n palpation, she had epigastric pain on pressure but no resistance to palpation. Investigations: Blood picture and routine laboratory tests were unremarkable. Plain film of the abdomen demonstrated marked gastr ic retention. Abdominal ultrasound showed an invagination in the gastr ic antrum suggesting a layering phenomenon. Gastroscopy revealed a sub mucosal tumour-like lesion with central ulceration which obstructed ga stric exit. Treatment and course: After conclusion of the diagnostic t ests on the first hospital day partial gastric resection (Billroth I) was performed as, in the absence of any surrounding reaction, a leiomy oma had been suspected. The further course was without complication an d she was discharged on the 13(th) hospital day. The surgical specimen revealed a duplication cyst of the gastric antrum. Conclusion: (Endo) sonography, computed tomography and endoscopy make it possible to diag nose duplication cyst, as long as it is included in the differential d iagnosis of acute abdomen in an adult. Emergency resection of the cyst is indicated because of the acute nature of the symptoms. But even in less urgent cases or as an incidental finding it is the treatment of choice.