Successful full-length sealing and division of the common wall in a 2-year-old boy with complete tubular colorectal duplication

Abstract

We report a case of complete tubular colorectal duplication that was treated with division through the full-length of the common wall using an articulating advanced bipolar sealing device. A 2-year-old boy who presented with excessive abdominal distension was found to have complete tubular colorectal duplication at laparotomy, and appendicostomy using the duplicated appendix was created temporarily to decompress the duplicated colon. Contrast colonography through the appendicostomy and abdominal MRI detected no luminal communication between the main and duplicated colon. Because the duplicated colon wall appeared equivalent to the main colon, which was confirmed histologically, surgical repair was conducted by dividing the septum between the main and duplicated colon using an articulating advanced bipolar sealing device, from the cecum to the rectum. The septum of the lower rectum was divided trans-anally with the same device. Postoperative colonoscopy confirmed the patency of a single common lumen of the entire colon and rectum. At two years after the operation, the patient was well except for mild and transitory constipation.