Esophageal duplications and bronchogenic cysts are aberrations of primitive foregut development. Duplications can be found along the entire length of the esophagus with varying presentation depending on its location and pressure effects on neighboring structures. Although duplications can remain asymptomatic, they may get discovered incidentally during unrelated investigations. The complicated duplications can present with life-threatening symptoms.
Differential diagnosis of posterior mediastinal rounded opacity on radiological investigation should include esophageal duplication cyst. Investigations such as an upper gastrointestinal contrast study and computed tomography of the chest are not diagnostic but can suggest duplication cyst. Once identified and investigated, the duplications should be resected.
Thoracoscopic surgery is recommended for resection of all uncomplicated and some complicated cysts. Thoracoscopic surgery reduces the hospital stay, postoperative analgesia requirement, and morbidity compared to open surgery. Although thoracotomy can achieve resection, it should be reserved for the complicated cysts. The outcome after complete resection is excellent. Surgical complications can be avoided by optical magnification and careful dissection close to the cyst. Incomplete resection results in recurrence. Surgical complications are related to inadvertent accidental injury to the surrounding vessels, nerves, thoracic duct, esophagus, and neighboring trachea. This chapter attempts to give an overview of the esophageal duplication and its current management.
Esophageal duplications Mediastinal cysts Thoracoscopic surgery Neuroenteric cyst
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