Management experiences of colorectal duplication in children: a report of 7 cases

Abstract

Objective To explore the diagnosis and treatment of colorectal duplications, and to improve its treatment outcomes. Methods Four boys and 3 girls with colorectal duplications between January 2001 and June 2017 were reviewed. Their clinical features, diagnosis, concomitant anomalies and treatment were retrospectively analyzed. The pathological examination verified the diagnosis. The onset time was from birth to 11 months old. And the diagnosis was confirmed from 2 days to 11 years old. There were 3 tubular shapes, 3 cystic types and 1 tubular/cystic type. The primary diagnoses were congenital anorectal disorders (n=3), currarino syndrome (n=1) and rectovesical fistula (n=1) and rectal navicular fistula (n=1) and rectourethral fistula with rectal prolapse. Only two cases were diagnosed correctly prior to initial operation. The concomitant disease included congenital anorectal disorders (n=4), currarino syndrome (n=1) and recto-urethral/rectovesical fistula & posterior urethral valves (n=3) respectively. Results For two cases of complete colorectal duplication with recto-urethral fistula, one underwent total colorectal resection & ileorectal anastomosis while another had duplication resection yet retained colorectal segment. For one case of long-segment colorectal duplication with recto-urethral fistula, septum of distal colon was removed with left colectomy. One case of colonic duplication with imperforate anus underwent septal resection and anoplasty. Three rectal duplications had thorough resection. An average of 3.57 (1-7) operations were performed. Anastomotic leakage occurred in one case of complete colorectal duplication after total colorectal resection. Severe postoperative soiling continued for 2 years and there was no other perioperative complication. Conclusions Based on our cases and literature review, we have adopted the following guidelines: (a) colorectal duplication is easily misdiagnosed for multiple clinical features; (b) preoperative evaluations should be conducted; (c) individualized solutions should be adopted after careful examinations. Key words: Duplication of intestine; Diagnosis; Treatment