Pediatric Gastroenterology, Hepatology & Nutrition

The Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition (대한소아소화기영양학회)
권호 표지
DOI QR코드

DOI QR Code

Tubular Colonic Duplication Presenting as Rectovestibular Fistula

  • Karkera, Parag J. (Department of Pediatric Surgery, Bai Jerbai Wadia Hospital for Children) ;
  • Bendre, Pradnya (Department of Pediatric Surgery, Bai Jerbai Wadia Hospital for Children) ;
  • D'souza, Flavia (Department of Pediatric Surgery, Bai Jerbai Wadia Hospital for Children) ;
  • Ramchandra, Mukunda (Department of Pediatric Surgery, Bai Jerbai Wadia Hospital for Children) ;
  • Nage, Amol (Department of Pediatric Surgery, Bai Jerbai Wadia Hospital for Children) ;
  • Palse, Nitin (Department of Pediatric Surgery, Bai Jerbai Wadia Hospital for Children)
  • Received : 2014.12.23
  • Accepted : 2015.02.09
  • Published : 2015.09.30
Download PDF
⟨ Previous Next ⟩

Abstract

Complete colonic duplication is a very rare congenital anomaly that may have different presentations according to its location and size. Complete colonic duplication can occur in about 15% of all gastrointestinal duplications. Double termination of tubular colonic duplication in the perineum is even more uncommon. We present a case of a Y-shaped tubular colonic duplication which presented with a rectovestibular fistula and a normal anus. Radiological evaluation and initial exploration for sigmoidostomy revealed duplicated colons with a common vascular supply. Endorectal mucosal resection of theduplicated distal segment till the colostomy site with division of the septum of the proximal segment and colostomy closure proved curative without compromise of the continence mechanism. Tubular colonic duplication should always be ruled out when a diagnosis of perineal canal is considered in cases of vestibular fistula alongwith a normal anus.

Keywords

References

  1. Macpherson RI. Gastrointestinal tract duplications: clinical, pathologic, etiologic, and radiologic considerations. Radiographics 1993;13:1063-80. https://doi.org/10.1148/radiographics.13.5.8210590
  2. Kekez T, Augustin G, Hrstic I, Smud D, Majerovic M, Jelincic Z, et al. Colonic duplication in an adult who presented with chronic constipation attributed to hypothyroidism. World J Gastroenterol 2008;14:644-6. https://doi.org/10.3748/wjg.13.644
  3. Merrot T, Anastasescu R, Pankevych T, Tercier S, Garcia S, Alessandrini P, et al. Duodenal duplications. Clinical characteristics, embryological hypotheses, histological findings, treatment. Eur J Pediatr Surg 2006;16:18-23. https://doi.org/10.1055/s-2006-923798
  4. Liu R, Adler DG. Duplication cysts: diagnosis, management, and the role of endoscopic ultrasound. Endosc Ultrasound 2014;3:152-60. https://doi.org/10.4103/2303-9027.138783
  5. Bryndorf J, Madsen CM. Ectopic anus in the female. Acta Chir Scand 1960;118:466-78.
  6. Ravitch MM. Hind gut duplication; doubling of colon and genital urinary tracts. Ann Surg 1953;137:588-601. https://doi.org/10.1097/00000658-195305000-00002
  7. Kaur N, Nagpal K, Sodhi P, Minocha VR. Hindgut duplication-- case report and literature review. Pediatr Surg Int 2004;20:640-2. https://doi.org/10.1007/s00383-004-1248-x
  8. Jellali MA, Mekki M, Saad J, Zrig A, Elanes I, Mnari W, et al. Perinatally discovered complete tubular colonic duplication associated with anal atresia. J Pediatr Surg 2012;47:e19-23.
  9. Inoue Y, Nakamura H. Adenocarcinoma arising in colonic duplication cysts with calcification: CT findings of two cases. Abdom Imaging 1998;23:135-7. https://doi.org/10.1007/s002619900305
  10. Aworanti O, Twomey E, Awadalla S. Terminal ileum and total colonic duplication associated with a rectovestibular fistula in a child. Ir Med J 2014;107:241-2.
  11. Yucesan S, Zorludemir U, Olcay I. Complete duplication of the colon. J Pediatr Surg 1986;21:962-3. https://doi.org/10.1016/S0022-3468(86)80106-3
  12. Ravitch MM. Duplication of the gastrointestinal tract. In: Ravitch MM, Welch KJ, Bandolph JG, eds. Pediatric surgery. 4th ed. Chicago: Year Book Medical, 1986:911-20.
  13. Fuchs JR, Clark K, Breckler FD, Rescorla FJ. Complete colonic duplication--a case report. J Pediatr Surg 2008; 43:E11-3.
  14. Stephens FD, Smith ED. Duplications and vesicointestinal fissure. In: Anorectal malformations in children: update 1988 (birth defects, original article series). New York: Alan R Liss, 1988:554-5.
  15. Craigie RJ, Abbaraju JS, Baath ME, Turnock RR, Baillie CT. Anorectal malformation with tubular hindgut duplication. J Pediatr Surg 2006;41:e31-4.
  16. Khaleghnejad Tabari A, Mirshemirani A, Khaleghnejad Tabari N. Complete colonic duplication in children. Caspian J Intern Med 2012;3:436-9.
  17. Zhang Z, Huang Y, Wang D, Su P. Rectosigmoid tubular duplication presenting as perineal sepsis in a neonate. J Pediatr Surg 2010;45:627-9. https://doi.org/10.1016/j.jpedsurg.2009.12.025
  18. Rathi V, Singh S, Bhargava SK, Kaur N, Seth N. Diagnosis of tubular colonic duplication by barium follow- through study. Australas Radiol 2005;49:157-9. https://doi.org/10.1111/j.1440-1673.2005.01363.x

Cited by

  1. Small Bowel Congenital Anomalies: a Review and Update vol.18, pp.4, 2015, https://doi.org/10.1007/s11894-016-0490-4
  2. Hindgut Duplication: A Unique Case of Six Perineal Openings vol.9, pp.7, 2015, https://doi.org/10.7759/cureus.1433