Tubular Sigmoid Bowel Duplication; an Unusual Endoscopic Finding in Adults

Abstract

Gastrointestinal duplication is an uncommon congenital abnormality which mostly presents in infancy or childhood. Tubular bowel duplication has sometimes been reported to present with rectal bleeding. Ileal duplication is common while colonic duplication, either cystic or tubular is a rather unusual clinical entity that remains asymptomatic and undiagnosed in most cases. Colonic duplication has primarily been reported in pediatric populations with only far fewer cases reported in adults. We report a case of asymptomatic tubular duplication of sigmoid colon in a 53 years old Caucasian male. Screening colonoscopy was done which revealed a sessile non-obstructing mass in the sigmoid colon 25 cm from the anal verge. The mass measured 5 cm in length and 12 mm in diameter. There was no bleeding from the mass and it was biopsied with a hot snare. Biopsy showed anomalous colonic mucosa lined by tubular structure consistent with tubular bowel duplication. The pathologists at Armed Forces Institute of Pathology had never identified a prior case demonstrating this pathology. To the best of our knowledge there has been no prior report of this pathologic finding in either medical or pathologic literature.