Rectal Duplication Cyst Research Articles

Rectal duplication cyst presenting with change in bowel habits and rectal bleeding: A case report and literature review

We present a rare case of rectal duplication cyst (RDC) in an adult patient who presented with chronic fluctuating bowel habits and rectal bleeding. A faecal immunochemical test (FIT) and a faecal Calprotectin level showed negative results, and no previous abdomen-pelvis CT scan or MRI was identified. A Colonoscopy was performed, showing a benign rectal lesion causing colonic intraluminal compression leading to rectal ulceration and prolapse, and solitary rectal ulcer syndrome was suspected. A Transanal Minimally Invasive surgery (TAMIS) was performed to excise the lesion, with histopathology findings consistent with a rectal duplication cyst. The patient had no intraoperative complications and made an uneventful recovery. A systematic literature review showed 30 30 adult Rectal supplication cyst case reports. In conclusion, The most common presentation of RDC is anal pain and rectal bleeding. The diagnosis of RDC is challenging, and it requires Surgical resection to confirm the diagnosis.

Neonatal Rectal Duplication Cyst: A Rare Presentation

Rectal duplication cysts are a rare clinical entity accounting for 4% of all intestinal duplications. The presenting symptoms depend upon their size, location and age of the patient. We report a rare neonatal presentation of rectal duplication cyst which was present as a swelling in the infracoccygeal region in a female child since birth. MRI suggested a cystic swelling adjacent to the rectum. Excision was done by posterior sagittal approach at 1 month of age. Histopathology confirmed it to be a rectal duplication cyst.

A Rare Case of Rectal Duplication Cyst presenting as a Posterior Perineal Hernia, in a Neonate

Rectal duplication is a rare entity and posterior perineal hernia is even so. Having both entities together poses a clinical challenge, however sticking to basic surgical principles helps in such situations.

Cloacal remnant with concomitant perirectal epidermoid cyst in an 8-year-old female

We present a healthy 8-year-old female with no past medical or surgical history who presents with perianal drainage. Exam noted a posterior perianal sinus tract with associated fullness on digital exam. Cross-sectional imaging demonstrated a peri-rectal cystic structure concerning for a rectal duplication cyst. On surgical exploration, the sinus tract and cystic mass did not communicate with each other, nor did they communicate with the rectum. Pathologic evaluation of the sinus tract demonstrated the presence of both urothelium and columnar epithelium, suggesting a cloacal remnant. The adjacent cystic structure was noted to be an epidermoid inclusion cyst. There is a wide variety of cloacal defects that have been reported, ranging in severity from inconsequential to severe. The relative scarcity of such defects, as well as the variability between patients and inconsistency seen in the literature, has resulted in limited standardization of diagnosis and treatment of these malformations. Our patient's presentation is most similar to congenital prepubic sinuses of cloacal origin. However, our patient had a unique presentation based on the anatomic location of her defect as compared to defects previously described, as well as the presence of the concomitant epidermoid cyst.

Cystic lesions of the retrorectal space.

Cysts of the retrorectal space comprise a heterogeneous group of rare lesions. Most develop from embryological remnants and include tailgut cysts, dermoid cysts, rectal duplication cysts, anal canal duplication cysts, sacrococcygeal teratomas and anterior meningocoele. Tailgut cyst is the most common cyst of developmental origin, usually presenting as a multilocular cystic mass with mucoid content and lined by multiple epithelial types. Compared with tailgut cysts, rectal duplication cysts display all layers of the large bowel wall including a well-defined muscularis propria. Retrorectal cysts of non-developmental origin are far less common and represent lesions that either infrequently involve the retrorectal space or undergo extensive cystic change. This review provides an overview of the various histological types of cystic lesions of the retrorectal space, divided into cysts of developmental origin and those of non-developmental origin. A practical pathological and multidisciplinary approach to diagnosing these lesions is presented.

A rectal duplication cyst with rectovaginal fistula: A case report

Alimentary tract duplications (ATD's) are rare congenital anatomical abnormalities. They have an incidence of 1 in 4500 live births and can occur anywhere throughout the digestive tract from the oropharynx to the anus. ATD's occurs most commonly in the midgut (56%), less commonly in the foregut (33%) and even more rare in the hind gut (11%). Rectal duplications are the least common among other alimentary tract duplications, forming only 4% of them. Typically, they are cystic masses, slightly more common in males and they can present in the newborns period or any time later in childhood and even adulthood. We describe a case of an adolescent female presenting with long standing constipation since birth associated with painful defecation and offensive stool odor, abdominal pain and distention. She recently noticed stool in the vagina at the time of defecation. Patient was admitted to our medical center for further investigations and underwent colonoscopy. The study showed two pouches in the rectum, one with blind end and ulcer with suspected fistula opening, and the other lumen continues to the cecum. Abdomen and pelvic CT with rectal contrast was also done, showing a huge recto-sigmoid duplication cyst compressing the native rectum. Evidence of contrast in the vagina was also seen. Decision for surgery was then made. The procedure commenced laparoscopically, showing a huge duplication cyst starting at the distal part of sigmoid and extending downward distally to the rectum. Severe adhesions and edema was also encountered (frozen pelvis) which forced us to convert to open surgery. It was not possible therefore, to perform complete excision of the cyst without risking to damage the rectum and surrounding structures, which will increase the morbidity significantly in our case. Moreover, the fistula was not seen from this approach, as it was very low. We eventually performed a near total cystectomy with the sigmoid attached to it, joined the common wall of the remaining of the cyst and the native rectosigmoid using endo-GIA staplers. We decided to exteriorize the proximal colon as end colostomy. Subsequently, the fistula was taken down trans -vaginally by the gynecology team as a second procedure . A third procedure was performed 6 months later, a laparotomy was performed, the colostomy was taken down and primary anastomosis was performed. No immediate postoperative complications were seen and the patient was discharged in good general condition. This is a unique case as it is a case of a huge rectosigmoidal duplication cyst that was discovered in a female at an adolescent age, causing severe adhesions and chronic inflammations in the pelvis which led to a rectovaginal fistula and made complete resection impossible without converting the surgery into a major surgery with risk of morbidity and long term sequela. As the condition is considered benign, the medical literature is usually against performing a major surgery that can be harmful to the patient like a very low anterior resection to excise the duplication cyst as it is acceptable to perform partial excision with unification the two lumens together which was performed in our case. This case is an example of multistage and multidisciplinary procedure to treat a rare duplication cyst anomaly.

Magnetic Resonance Imaging in Giant Perianal Epidermoid

AbstractPerianal epidermoid cyst is a rare entity and is commonly diagnosed late owing to its slow-growing nature. Imaging plays a vital role in diagnosis and differentiation from other cysts such as dermoid, tailgut, and rectal duplication cysts. Magnetic resonance imaging (MRI) is the preferred modality as uncomplicated cases show typical signal changes. Diffusion-weighted imaging has a definite additional role. We report a case of a giant perianal epidermoid diagnosed on MRI and successfully managed surgically.

Rectal duplication cyst mimicking rectal prolapse: A case report

Background: Gastrointestinal tract duplications are rare congenital malformations that are benign, presenting usually in childhood. Most common sites include the distal ileum and esophagus. Rectal presentation is quite uncommon and is usually cystic. Case Presentation: This is a case of a 3-year-old boy who came with rectal prolapse. On further examination and imaging investigations, a presacral cyst was located and a diagnosis of rectal duplication was made. The cyst was completely excised by a posterior sagittal approach. Conclusion: Rectal duplication is a rare entity that may simulate a rectal prolapse.

Erratum to ‘Rectal duplication cyst presenting as rectal prolapse in an infant’ [Journal of Pediatric Surgery Case Reports Volume 32, May 2018, Pages 49-52

Erratum to ‘Rectal duplication cyst presenting as rectal prolapse in an infant’ [Journal of Pediatric Surgery Case Reports Volume 32, May 2018, Pages 49-52

Rectal duplication cyst: a rare surgical case in a child.

Rectal duplication cyst: a rare surgical case in a child.

CHRONIC CONSTIPATION IN INFANTS: THINK ABOUT RECTAL DUPLICATION

Rectum is the least common site of gastrointestinal duplication. Up to now fewer than 100 cases have been reported in the literature. We present two infants with cystic rectal duplications manifested with chronic constipation as a main clinical symptom. The first patient was a 4-year-old boy who was admitted to emergency department because of chronic constipation unresponsive to fiber supplements and laxatives. Digital rectal exam revealed mass adjacent to posterior rectal wall. Abdominal ultrasound and magnetic resonance imaging confirmed oval, homogenous and hypoechogenic cystic mass (87x65x60 mm in size) behind the rectum. The size and location of the cystic mass was confirmed by magnetic resonance imaging. The second patient was an 11-month-old boy who was hospitalized due to rectal bleeding. He was suffering from chronic constipation over the last five months. Digital rectal exam revealed a mass behind the rectum. Abdominal ultrasound and computed tomography showed unilocular cyst (33X33 mm in size) in front of the urinary bladder, partly extending into retrorectal space. Both patients were operated on. Postoperative periods were uneventful in both of them. Cystic rectal duplication must be ruled out in all infants with chronic constipation unresponsive to conservative treatment. Different imaging techniques are currently used to determine the precise size and location of duplication. Surgery is the only possible therapy option.

A Late Adolescent Girl with Rectal Duplication Cyst in Bangladesh: Case Report

Intestinal duplications, originally described in 1941, are congenital cystic lesions resemblingand associated with part of the gastrointestinal tract. Rectal duplication is the rarest of the allduplications and adolescence presentation of rectal duplication cyst is quite unusual whichis reported here. A 17 year female presented with right gluteal lump. She underwent surgeryand was found to have a smooth cystic mass, which was later found to be a Rectal Duplicationcyst in histopathology. High index of suspicion with other differentials can lead to earlydiagnosis and complete cure of the condition.
 Journal of Surgical Sciences (2017) Vol. 21 (1) :45-46

An unusual rectal duplication cyst

BackgroundRectal duplication cysts are rare gastrointestinal congenital duplicate cysts with various clinical presentations that require different management.Case presentationWe present a case of a lady with a double rectal duplicate cyst which was found incidentally on a follow-up CT abdomen and pelvis scan. The patient initially had a mucocele excision, and following that, she had a non-contrast CT abdomen and pelvis to investigate post-operative pain. The CT scan revealed a single rectal duplicate cyst. She had a posterior approach excision to have it removed, and only intra-operatively, she was found to have a double rectal duplicate cyst. She had them both removed via a midline incision running from the perineal pigmentation and extending until the coccyx. She had another follow-up CT which showed complete excision of the cysts.ConclusionsAfter a thorough review of the literature regarding rectal cysts, there was no mention of a double rectal duplicate cyst. The purpose of this paper is to point out the various potential presentations of a rectal cyst as well as the idea that a double cyst is managed effectively in a similar way as the single one.

Case Report: Trans-Vaginal Excision of Anterior Rectal Duplication Cyst in an Adult

AbstractCase Report: We present an extremely rare case of anterior rectal duplication cyst in a 36-year old female patient. The patient presented with deep perineal pain, constipation, and severe dyspareunia. Pelvic examination showed a mass in the rectovaginal space. The condition has been diagnosed by MRI. The cyst was completely excised through transvaginal approach due to its lower anterior location. The transvaginal approach was safe, easy and was followed by well-preserved anal functions. Post-operative histopathological examination confirmed the diagnosis of rectal duplication cyst. The patient was followed for one year and she reported complete disap-pearance of her pre-operative symptoms.Conclusions: Although anterior rectal duplication is an extremely rare condition, it should be put into consideration in managing patients with pararectal cysts. MRI is an efficient radiological investigation that accurately describes the cyst and its relation to surrounding structures. Transvaginal ap-proach is a safe and easy approach to excise these lesions, especially when they have a low anterior location.

Rectal duplication cyst presenting as rectal prolapse in an infant

Abstract Rectal duplication is a rare variety of gastrointestinal duplication. It accounts 4% of the total gastrointestinal duplications. In this paper, we are reporting a case of an 8 months old male who presented with rectal prolapse. Digital rectal examination revealed a soft mass bulging through the posterior wall of rectum. Computed tomography (CT) scan showed a cystic mass compressing the posterior wall of the rectum. The mass was excised using a Muscle Complex Saving Posterior Sagittal approach (MCS-PSA). The pathology report confirmed the diagnosis of the rectal duplication cyst. The postoperative recovery was uneventful.

Epidemiological characteristics of Hirschsprung’s disease (HSCR): Results of a case series of fifty patients from Bangladesh

BackgroundThe epidemiology of Hirschsprung's disease (HSCR) in Bangladesh has never been studied. The aim of this study was to determine the epidemiological characteristics of HSCR in Bangladesh. MethodsData from fifty patients were collected prospectively from two hospitals in Chittagong, Bangladesh. ResultsThe rate of consanguinity (16%) among parents of HSCR patients was higher than that of the general population (10%). Maternal age at the time of birth of the affected child was ≤30years in all cases except one. No association was found between parents' occupation and HSCR. No patient was born preterm and only three patients (6%) had low birth weight. Nine patients (18%) had associated anomalies. We found coexistence of bilateral accessory tragi and ankyloglossia in one patient, and coexistence of rectal duplication cyst in another. Neither anomaly had been previously reported in HSCR patients. ConclusionsOur study suggests that consanguinity might increase the risk of HSCR whereas advanced maternal age does not. HSCR patients were found more likely to born at term and with normal birth weight. The coexistence of HSCR with previously unreported anomalies highlights the diversity of conditions that can co-occur with HSCR. Levels of evidenceIV

Wide rectal duplication cyst in an adult resected by anterior approach: efficacy and recurrence

Alimentary tract duplications are uncommon congenital abnormalities usually diagnosed and treated in childhood. Rectal involvement is extremely rare. We report the case of a 22-year-old female who presented with chronic abdominal and perianal pain; feeling of rectal fullness. Workup revealed a rectal duplication cyst. The patient underwent a complete transabdominal excision of the cyst: an hybrid laparoscopic and laparotomic technique was adopted. The hybrid isolated anterior abdominal approach is safe and feasible even for the treatment of wide rectal duplication cysts. Real recurrence in rectal duplication cysts is uncommon when the first operation was performed with radical intent.

AN UNUSUAL PRESENTATION OF RECTAL ATRESIA WITH RECTAL DUPLICATION CYST IN A NEONATE: A CASE REPORT

A 10 days old male baby brought with abdominal distension and cystic swelling in the left buttock. Radiological investigations suggested para-rectal abscess or rectal duplication cyst. Patient underwent transverse loop colostomy and later definitive surgery by posterior sagittal approach. Intra-operative findings were suggestive of small atretic rectal segment with duplication cyst of the rectum. To the best of our knowledge, neonatal rectal atresia with rectal duplication cyst has not been reported in English literature.

Tailgut Cyst: a Case Report in a Female Neonate

Tailgut cyst, or retrorectal cystic hamartoma, is a rare congenital lesion found in the presacral space. The lesion has been infrequently reported in the literature. We report a 16 days female neonate presented with urine retention. the retrorectal or presacral space (4) and rarely in the perirenal area (2,3,5), the subcutaneous tissue in the anorectal region (6) and more rarely in the prerectal location. Microscopically, the tailgut cyst is characterized by the presence of a cysts lined with varying types of epithelium; columnar, mucin secreting epithelium predominates, while other areas of squamous and transitional epithelium often coexist (7). The differential diagnosis of cystic masses in this space includes sacrococcygeal teratoma, dermoid cysts and other complex ovarian masses, rectal duplication cysts, anterior meningoceles, cystic lymphangiomas and abscesses (8,9). There is an approximately 3:1 female preponderance of cases reported (4). Uncomplicated lesions are typically asymptomatic, and patients usually come to medical attention when the cyst becomes infected or when the lesion is incidentally discovered either radiologically or during physical examination. Perineal pain, pain with defecation, painless rectal bleeding, urinary frequency, and change in stool caliber have been reported. A few rare cases of malignant change associated with a tailgut cyst have been reported, but none in children to our knowledge (4,10,11). Few cases have been reported in children. The largest series by Hjermstad and Helwig (4) at the Armed Forces Institute of Pathology describes 53 cases of the entity collected during a 35-year period. Five cases demonstrating the CT and sonographic findings of tailgut cysts were described by Johnson et al. (12) at the Armed Forces Institute of Pathology. There are only a handful of reports of the MR findings of this entity in adults and only a few cases in the pediatric population (13).

Enteric Duplication Cysts in Children: A Clinicopathological Dilemma.

Enteric duplication cysts are rare and uncommon congenital malformations formed during the embryonic period of the development of human digestive system and are mainly encountered during infancy or early childhood, but seldom in adults. The clinical presentation is extremely variable depending upon its size, location and type. We present six cases of enteric duplication cysts with diverse clinico-pathological features. This study was carried out in the Department of Pathology and Department of Paediatric Surgery, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India for a period of 2 years (January 2013 - December 2014). We retrospectively analyzed six patients of enteric duplication cysts based on data obtained, which consisted of patient's age, sex, clinical presentation, radiological features, operative findings and histopathology report. The data collected was analyzed by descriptive statistics. Six children between age range of 3 days to 10 years had enteric duplication cysts. Two had ileal and one each were of pyloroduodenal, colonic and rectal duplication cyst. In one patient a presumptive diagnosis of enteric duplication cyst was made. Radiology played an important contributory role in diagnosis of these cysts in all the patients but histopathology proved to be gold standard for its confirmation. All these patients were managed by surgical excision. The postoperative and follow up period in all the cases was uneventful. It is important to be aware and make a definitive diagnosis of this rare congenital anomaly as they can present in various clinical forms and can cause significant morbidity and even mortality if left untreated by causing life threatening complications.