Chronic gastroesophageal reflux disease secondary to a distal esophageal duplication cyst associated with a hiatal hernia

Summary Background Esophageal duplication cysts are asymptomatic gastrointestinal anomalies that are infrequently seen, usually diagnosed as a secondary finding. In adults, they can be associated with gastroesophageal reflux disease (GERD) and are usually detected with a radiologic study. Methods We report the case of a 55-year-old woman with a 2-year history of pyrosis, regurgitation, coughing fits, and dysphagia. An esophagogastroduodenoscopy (EGD) was done, detecting a subepithelial lesion at the gastroesophageal junction with a type I hiatal hernia; endoscopic ultrasound and a CT scan were performed, showing a distal esophageal mass that generated a narrowing of the esophageal diameter with proximal dilation. Results An esophageal duplication cyst was diagnosed. Excision of the mass, hiatoplasty, and gastric fundoplication were auspiciously achieved by an abdominal transhiatal approach. A year after the procedure, the patient is asymptomatic and without complications. Conclusion If a patient presents with epigastric pain and GERD-like symptoms, with no benefit from medical treatment, an esophageal duplication cyst must be a differential diagnosis. This can be confirmed with a CT scan and endoscopic ultrasound, with surgery being the best treatment for this disease