Annals of Pediatric Surgery (Aug 2023)
Tubular colonic duplication: a case report and brief review of the literature
Abstract
Abstract Background The 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 presentation In 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. Conclusions Tubular 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.
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