Colonic Duplication Research Articles

042. Colonic Duplication with Recto-Vestibular Fistula: A Case Report

Background: Anorectal malformations associated with colonic duplications are a rare condition. Colonic duplication may have different presentations according to its location and size, with an incidence of less than 15% of all gastrointestinal duplications. Colonic duplication is less common than ileal duplication, whether cystic or tubular. Duplications are considered congenital malformations because they are thought to arise from disturbances in embryonic development. This report aims to present and analyze the clinical presentation, diagnostic approach, and management of anorectal malformations associated with colonic duplications in an 11-month-old child at our hospital, highlighting the challenges and treatment strategies for such a rare case. Case: We present a case of an 11-month-old girl, referred from a network hospital with a post-colostomy at 4 months of age for recto-vestibular fistula with findings of colonic duplications at colostomy. Exploratory laparotomy was performed until the colonic duplications were identified and completely resected. Conclusion: Colonic duplication is a rare congenital disorder, and its association with anorectal abnormalities is even rarer. The surgical treatment includes resection of the duplicated colon. Surgical intervention is the treatment of choice.

Tubular adenoma arising in tubular colonic duplication: a case report.

Colonic duplication constitutes a rare congenital anomaly, characterized by the presence of hollow cystic or tubular structures exhibiting an epithelial-lined intestinal wall. Diagnostic challenges persist due to its low incidence and manifestation of nonspecific symptoms such as abdominal pain or constipation, resulting in a reluctance to pursue surgical resection. As associated malignancies in colonic duplication are rare, the inherent malignant potential of these anomalies remains undetermined. Additionally, despite reported instances of associated malignancies in colonic duplication, there is an absence of reports in the literature detailing tubular adenoma within these cases. The histologic features of the presented case are particularly noteworthy, situated at the precancerous stage, intimating potential progression towards adenocarcinoma within colonic duplication.

Duplication of the transverse colon: A rare cause of abdominal pain in an adult male

Duplication of the transverse colon: A rare cause of abdominal pain in an adult male

Underwater Endoscopic Resection: A Novel Treatment of Colonic Duplication Cysts

Underwater Endoscopic Resection: A Novel Treatment of Colonic Duplication Cysts

Tubular duplication of the sigmoid colon: clinical case

Patient B., 45 years old admitted with signs of complicated diverticular disease. Complaints since 2021 of periodic pain in the lower abdomen, false urge to defecate. Repeated abdomen CT and contrast enema revealed a blindly ending duplication of the sigmoid colon up to 15 cm in length. The patient underwent laparoscopic resection of a duplicated portion of the sigmoid colon. The was favorable at the time of discharge.

Colonic Duplication Cyst with Gastric Heterotopia Haemorrhage and Mucosal Ulceration: A Case Report

Present report relates to duplication of ascending colon with cyst formation along with ectopia of gastric glands in lamina propria of colon. Heterotopia or ectopia is defined as presence of an organ outside its normal anatomic site. Ileum is the commonest site of heterotopia in gastrointestinal tract. Rarely, heterotopia may involve ascending colon. In the present case, cyst wall also had a thickened area, measuring 1×1×0.5 cm, consisting of hypertrophic muscularis. Cyst wall showed ulceration in continuity with colonic columnar epithelium. In addition, lamina propria also showed mixed leucocytic infiltration. The lesion was finally diagnosed as duplication of ascending colon with cyst formation and heterotopia of benign gastric glands, hemorrhage and ulceration. Keywords: Large intestinal cyst with two corresponding parts, ectopia of gastric glands with ulceration and haemorrhage.

Congenital Partial Colonic Agenesis in Dogs and Cats: Clinical, Biological, Diagnostic Imaging, Endoscopic and Histopathologic Characterization, a Retrospective Study.

Congenital diseases of the large intestine of dogs and cats have scarcely been reported and mostly include fistula, atresia or colonic duplication. Cases of partial colonic agenesis have rarely been described. The purpose of this study was to report a cohort of dogs and cats diagnosed with partial colonic agenesis. The colon was measured during colonoscopy or contrast-radiography and compared to the average length described in the literature. Six dogs and 17 cats were retrospectively included. Depending on the case, partial colonic agenesis could represent an incidental finding or the likeliest cause of clinical signs. Diarrhea was reported in most cases, and no specific clinical or biological abnormality was observed. Median age of presentation was variable and long asymptomatic periods were common. Abdominal ultrasound was useful and identified a short colon in 14/17 cats but only in one dog. Endoscopy was useful to confirm the diagnosis and to identify associated lesions and complications. Among others, colonic stenosis was reported in 8/9 cases that had lifelong clinical signs and the shortest colon length. This anatomical abnormality could promote chronic inflammation that might generate fibrosis and ultimately stenosis.

Tubular colonic duplication: a case report and brief review of the literature

BackgroundThe occurrence of complete tubular colonic duplication is exceedingly rare. In most cases, resection of the duplicated colon may not be possible because of common blood supply with a single mesentery shared between the duplication and associated original bowel (Karkera et al., Pediatr Gastroenterol Hepatol Nutr 18:197-201, 2015).Case presentationIn this paper, we present a case of a 9-month-old girl who was noticed to pass stools through her vagina since birth despite normal anus in place, in association with constipation and pain on defecation. On local examination, a vestibular fistula was found. Further management including fistulogram, barium enema, and laparoscopy were performed. She was found to have tubular T-shaped colonic duplication with separate lumens from the mid-transverse colon downwards. Due to a shared fused wall, a decision was made to create a side-to-side (window) anastomosis at descending colon level using GIA staplers and end-to-side anastomosis at a sigmoid level between duplicated and normal colons with (mucosectomy) of duplicated colon down to the perineum.ConclusionsTubular colonic duplication should be kept in mind in patients presenting with vestibular fistula and fecal soiling in the presence of a normal anus. Minimal-invasive procedures are a safe and good alternative.

Colonic Duplication Cyst with Gastric and Pancreatic Heterotopia: A Case Report

Colonic duplication is an uncommon congenital anomaly within the alimentary tract which may be missed on clinical examination. Clinical symptoms are generally related to the involved site, size of duplication, or the associated ectopic mucosa. This is a case report of a 7-month-old female patient admitted in septic and hypovolemic shock, with severe anemia. Ultrasonography and computed tomography (CT) scans showed a left flank mass suggesting intussusception. The patient was first stabilized with intravenous fluids, intravenous antibiotics, oxygen, and blood transfusion. At laparotomy, the findings were a left paracolic cystic mass and an adjacent, complex retroperitoneal hemorrhagic mass. The histopathology report was consistent with a colonic duplication cyst with ectopic gastric and pancreatic mucosa. The patient improved after surgery and was discharged for routine outpatient follow-up. Colonic duplication should be included in the differential diagnoses in children presenting with palpable abdominal masses. Complete surgical removal of the symptomatic duplication is the treatment of choice.

A Case of Y Tubular Duplication of the Sigmoid Colon in a Pediatric Patient.

A Case of Y Tubular Duplication of the Sigmoid Colon in a Pediatric Patient.

Surgical treatment of a patient with tubular colonic duplication complicated by perforation and peritonitis

We present successful treatment of a patient with tubular colonic duplication complicated by fecal impaction, perforation and fecal peritonitis. This anomaly is usually detected in children younger 2 years old. In adulthood, this diagnosis is of a precedent-setting nature. If the diagnosis was not confirmed in early childhood, the absence of typical clinical picture, long-term course of disease and difficult interpretation of clinical data complicate subsequent verification of congenital anomaly. Only infectious complications and emergency surgery in adults can make a correct diagnosis.

Laparoscopic right hemicolectomy for rare case of caecal duplication cyst manifested as intussusception in an adult: a case report

Duplications of the alimentary tract are very rare congenital anomalies, and of which two thirds of cases manifest before the age of two years. Among duplication of alimentary tract colonic duplications are unusual, they may remain asymptomatic and present in adulthood. This report discussed a case of a 26-year-old female who presented with abdominal pain due to colocolic intussusception. Right hemicolectomy was performed for same and the diagnosis of a caecal enterogenous cyst was confirmed by histopathological exam. This report implied that although alimentary tract duplications are rare, they should be considered in any case presenting with abdominal pain. Laparoscopic right hemicolectomy can be performed for good cosmetic results, less morbidity and early recovery.

Sigmoid colon duplication seen as a rare cause of ileus in adult: case report

Intestinal duplications are congenital anomalies usually seen in infancy. Since it is congenital, they often become symptomatic in childhood. Usually diagnosed by adulthood. Those seen in childhood are mostly seen in the part from the oral cavity to the middle of the transverse colon, which is defined as the foregut and midgut embryologically. In our case report, we presented a female patient who was diagnosed both in adulthood and presented with ileus caused by duplication in the sigmoid colon. A 24-year-old female patient was admitted with the complaints of intermittent constipation and inability to pass gas and stool for 3 days. It was thought that the pathology observed in the sigmoid colon in the abdominal CT with contrast was due to torsion. Urgent surgery was decided for the patient. During the operation, it was observed that there was duplication in the sigmoid colon and torsion developed due to this. The patient underwent anterior resection and end-to-end anastomosis. She was discharged with surgical recovery in the postoperative period. Intestinal duplications are congenital anomalies that are usually seen in infancy. However, although rarely, it can be detected in adulthood, as in the patient we presented. Duplication anomalies should be kept in mind in the differential diagnosis of patients with chronic constipation and abdominal pain.

Recto-vestibular fistula with colonic duplication: report of three cases and review of literature

BackgroundAnorectal malformations associated with colonic duplications are a rare condition. Double terminations of tubular colonic duplication in the perineum are even rarer. Colonic duplication may have different presentations according to its location and size and incidence of less than 15% of all gastrointestinal duplications. We hereby report three such cases of recto-vestibular fistula along with underlying tubular colorectal duplication over a period of 10 years (2010–2020) managed successfully by different surgical approaches. These cases also illustrate the diagnostic challenge and variable presentation of colonic duplications in female patients with recto-vestibular fistula.Case presentationCase 1 is a patient with flank heteropagus with absent anal opening and recto-vestibular fistula, while cases 2 and 3 presented as suspected H-type recto-vestibular fistula with normal anal opening. All the cases were however managed with a specific surgical approach on case basis. Duplicated colon was excised in case 1, but in case 2 and case 3, duplicated colon was converted into single channel using proximal and distal staplers. Further definitive repair of female recto-vestibular fistula was done.ConclusionsColorectal duplication is a rare congenital malformation, and their association with anorectal malformations is even rarer. This association can have varied presentation, and surgical approach should be according to the congenital anatomical variations on case-to-case basis. Colonic duplications should always be ruled out in a female newborn child with history of passage of stools both from the vestibule and anus.

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

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.

Congenital perineal defect with rectal duplication and extreme hypospadias\u2014a rare association

BackgroundCongenital perineal hernia is an extremely rare entity with only 10 cases having been reported in literature. We report a newborn with exposed bowel loops coming out through a defect in the perineum to the right of the median raphe and propose the term perineoschisis for this abnormality. The exposed bowel loops were a sequestered segment of colon. The baby also had extreme perineal hypospadias and left undescended testis.Case presentationA term neonate, born of caesarean section, was noted at birth to have exposed bowel loops visible in the perineum. The bowel loops were not covered by any membrane. To avoid injury to the exposed bowel loops and setting in of infection, the baby was taken up for emergency surgery. At laparotomy, the bowel loops were traced from duodeno–jejunal junction to ileocecal junction and sigmoid colon and rectum. No loops were seen herniating outside from the abdomen through the perineum opening. The extruded bowel loops were sequestered and ending blindly close to the rectum. The sequestered bowel loops were excised completely and perineum reconstruction was done.ConclusionThe extruded bowel loops would appear to be a form of colonic duplication with the duplicated colonic loops herniating outside through an opening in the perineum. Since the bowel loops were lying to the right of median raphe and were not covered by hernia sac or any other membrane we propose the term perineoschisis for this abnormality. The baby also had extreme hypospadias with a perineal meatus, bifid scrotum and penoscrotal transposition. This association of herniated duplicated colon with extreme hypospadias is hitherto unreported to the best of our knowledge.

Complete tubular colonic duplication ending in a common channel as a recto vestibular fistula: A case report and literature review of management options

Colon duplication (CD) is a rare congenital abnormality with varied presentations. We present a neonatal case with complete tubular CD terminating uniquely as a common channel, a single rectovestibular fistula. We summarize surgical management options in CD as well as factors that will help to decide the best surgical treatment in individual cases.

Клиническое наблюдение редкого варианта аноректальной мальформации – стеноза ануса с передним удвоением прямой кишки

In this article, we report a rare case of anorectal malformation (anal stenosis) in combination with anterior communicating rectal tubular duplication in a 10-month-old boy. The patient presented with constipation, bloating, anal narrowing, and an additional opening in the anterior semicircle of the anal sphincters. His diagnosis was confirmed by contrast-enhanced computed tomography. Surgical treatment was conducted by stages and included colostomy, rectal duplication removal with anterior sphincteroplasty, and stoma closure. One year postoperatively, the child had regular stools, no fecal incontinence, and a good cosmetic result of the operation. We emphasized late diagnosis of this congenital malformation. In case of an additional opening in the anterior semicircle of the anus, it is necessary to exclude colonic duplication using visualization methods. Digital rectal examination is recommended to exclude anal stenosis in such patients. Key words: anorectal malformations, anal fistula, colonic duplication

Total Colonic Tubular Duplication Including Terminal Ileum and Appendix: A Rare Case

Total Colonic Tubular Duplication Including Terminal Ileum and Appendix: A Rare Case

Clinical features of colorectal duplication in children: A study of 25 cases

PurposeTo describe the clinical features and surgical management of pediatric colorectal duplication. MethodsTwenty-five patients with colorectal duplication at Beijing Children's Hospital between January 2010 and December 2020 were reviewed. Colorectal duplications were divided into cystic, diverticular, tubular and mixed types according to shape. ResultsOf the patients, 64% were female, and 44% had accompanying malformations. Abnormal prenatal ultrasound findings (24%), abnormalities immediately found after birth (28%), and postnatal subjective symptoms (48%) were the main clinical presentations. Cystic lesions were observed in 16 patients (64%), including 12 in the colon and 4 in the rectum. Diverticular lesions were observed in 4 patients (16%), and all originated from the sigmoid colon. Among the 4 patients (16%) with tubular lesions, 3 involved the total colon, and the other originated from the splenic flexure to the proximal sigmoid colon. The patient with mixed duplication presented an intact enteric cyst within tubular duplication of the total colon. The mean age at surgery was 20 (0.3–130) months. Except for 4 total colon duplications, complete surgical resection of duplication lesions was performed in all patients. The “distal cross-section, mucosa stripping, and closure” procedure was performed in 3 patients with total colon duplication. Eighteen patients (72%) were followed up for a median time of 54.5 (5–129) months and recovered uneventfully. ConclusionsOwing to various clinical presentations, colorectal duplication requires careful preoperative differential diagnosis. Complete surgical resection is the preferred radical method for treating cystic, diverticular and short tubular colorectal duplications, except for total colon duplications. Level of EvidenceLevel IV.