Colonic duplication presenting as a huge abdominal mass in an adult female

Kung-Chuan Cheng,Ko-Chao Lee,Sheung-Fat Ko

doi:10.1007/s00384-019-03409-9

Kung-Chuan Cheng, Ko-Chao Lee + Show 1 more

Open Access

https://doi.org/10.1007/s00384-019-03409-9

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Abstract

IntroductionDuplications of the alimentary tract are a rare congenital malformation. Most of the cases are symptomatic and diagnosed before 2 years of age. Here, we report a young female presented with a huge abdominal mass, and colonic duplication was confirmed during laparotomy.Case presentationA 29-year-old female had chronic constipation treated with laxative agents. She presented to the emergency room with abdominal cramping for 3 days, accompanied with intermittent fever and vomiting. A huge movable abdominal mass was noted during physical examination. Computerized tomography showed a long segmental dilated bowel lumen with stool impaction and bowel wall thickening of the dilated lumen in the left abdomen, highly suggestive of a long tubular colon duplication. The patient underwent subtotal colectomy. Specimen subsequently confirmed the diagnosis for colonic duplication from cecum to sigmoid colon, and the duplicated colon was found on the antimesenteric side of the native colon. She had a stable postoperative course and was discharged 9 days later.DiscussionDuplications of the alimentary tract are a rare congenital anomaly. Colonic duplication is an even more unusual malformation of this type. It can be classified into cystic or tubular type according to the gross morphology and may or may not be associated with other congenital anomalies. Most common presentation includes abdominal distention, refractory constipation, and bowel obstruction like many other colorectal conditions. Thus, its indistinct symptoms make it difficult to be diagnosed preoperatively. The recommended treatment is surgical resection of the duplicated lumen along with the attached native colon.

Highlights

Duplications of the alimentary tract are a rare congenital malformation
We report a case of a young female with a tubulartype colonic duplication from the cecum to the sigmoiddescending colon junction presenting to our emergency room as a huge abdominal mass
Duplications of GI tract are defined as (1) a microscopic structure resembling the normal bowel, having mucosa, muscle layers, and serosa; (2) lining with a mucosa similar to some portion of the alimentary tract; and (3 ) lesions that are contiguous with some portion of the intestinal tract [2]

Summary

Discussion

Duplications of the gastrointestinal tract are rare These anomalies can develop anywhere along with the alimentary tract and are most commonly found in the small intestine. The tubular type of gastrointestinal duplication contributes to less than 20% of cases. Such lesions can present in T-shape or Y-shape and are frequently associated with concurrent genitourinary anomalies or colovesical fistula [3]. Owing to non-specific and a wide variety of abdominal symptoms, the diagnosis of colonic duplication could be very challenging. We report a very rare tubular type of colonic duplication without any genitourinary or other congenital defect in an adult, presenting with a huge abdominal mass initially.

Introduction

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