Abstract
BackgroundIntestinal duplication, a congenital malformation, is considered a rare condition, particularly in adults. Although it affects young children, a minority of patients remains asymptomatic until adulthood. Here, we describe a case of an intestinal duplication cyst that caused intussusception by a unique mechanism.Case presentationA 19-year-old man was admitted to our hospital for intermittent abdominal pain. Computed tomography revealed colonic intussusception induced by a nodular mass in the ileocecal region. Urgent ileocecal resection was performed because of the risk of colonic ischemia. The resected material comprised a stool-filled noncommunicating cyst that protruded into the enteric lumen at the ileocecal valve. Histological analyses revealed that the inner wall of the cyst was lined with colonic mucosa and that the muscle layer of the cyst was shared with that of the original enteric wall; furthermore, the cyst had a vestige of an opening site in the wall. We concluded that the cyst was an intestinal duplication that poured stool into its lumen through the tiny orifice, thereby triggering intussusception.ConclusionsThe present case suggests that stool-pouring can cause intussusception into the space of an intestinal duplication lesion.
Highlights
Intestinal duplication, a congenital malformation, is considered a rare condition, in adults
Intestinal duplication was first described by Fitz in 1884 [6]; in 1937, Ladd provided a detailed description of the clinical and pathological aspects of duplication of the alimentary tract as a congenital malformation [7]
The duplication lesion shares a portion of its wall with that of the adjacent alimentary tract, usually sharing a common blood supply [8]
Summary
Alimentary tract duplication, a congenital malformation, occurs in approximately 1 out of 10,000 births. Ileac or ileocecal duplication is rather common in this condition. Intestinal duplication has recently attracted attention as a cause of intussusception in young adults [4, 5]. Our present case further elucidates this condition. Case presentation A 19-year-old male was referred to our hospital by a primary care physician for a history of intermittent cramping pain in the right flank persisting for several days. His abdomen was flat and soft; he complained of
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