BACKGROUND Alimentary tract duplication(ATD) is a rare congenital anomaly.Thus,a case of ATD with a complete colonic duplication isolated in the abdominal cavity with a fistula and multiple malformations is very disti...BACKGROUND Alimentary tract duplication(ATD) is a rare congenital anomaly.Thus,a case of ATD with a complete colonic duplication isolated in the abdominal cavity with a fistula and multiple malformations is very distinctive.These characteristics show the variability of this disease and explain why it tends to be challenging to diagnose and treat.CASE SUMMARY A 25-year-old woman with a history of a fistula opening in her right hip since birth presented with the irregular discharge of foul fluid from the fistula and intermittent abdominal pain.Contrast-enhanced computed tomography and magnetic resonance imaging findings revealed a duplicated tube isolated in her abdominal pelvic cavity along with a pelvic malformation and double ureter.Right foot radiographic examination showed pes cavus.During surgery,the tube appeared to be an almost complete colonic structure and was verified to be connected to the fistula.All of the involved tissue and fistula were removed,and the defect in the pelvic floor was closed by suturing after surgery.After 8 mo,the postoperative follow-up has been uneventful.CONCLUSION ATD may be a differential diagnosis in sinus tract cases.Laparoscopy combined with open surgery is a viable treatment option.展开更多
BACKGROUND Alimentary duplication is a rare congenital disease with a reported incidence of 1 per 4500 persons,although the exact incidence has been difficult to ascertain.According to previous reports,the most common...BACKGROUND Alimentary duplication is a rare congenital disease with a reported incidence of 1 per 4500 persons,although the exact incidence has been difficult to ascertain.According to previous reports,the most common site of duplication is the ileum,and colonic duplication is rare.Due to different types and locations of the duplication,the manifestations are varied,which makes establishing an accurate diagnosis before surgery a challenge.CASE SUMMARY A 17-year-old female patient sought evaluation in our department with constipation and chronic abdominal pain for 12 years;she had difficulty defecating and had dry stools since she was a child.An abdominal computed tomography revealed two extremely enlarged loops of bowel full of stool-like intestinal contents in the left lower abdomen,which led us to consider the possibility of colonic duplication.A laparoscopic exploration was performed,which revealed a tubular duplicated colon that shared a common opening with the transverse colon.A left hemi-colectomy was performed with a side-to-side anastomosis.The pathologic results confirmed the diagnosis.At the 6-mo followup,the patient was doing well without constipation or abdominal pain.CONCLUSION Colonic duplication is a rare alimentary abnormality in adults.Due to the nonspecific manifestations and low incidence,it is usually difficult to make an accurate diagnosis pre-operatively.Surgery is the mainstay of treatment,even though some patients are asymptomatic.展开更多
BACKGROUND Colonic duplication refers to a spherical or tubular cavity which shows similar properties with the native colon and is attached to the mesenteric side of the alimentary tract.It is the rarest in alimentary...BACKGROUND Colonic duplication refers to a spherical or tubular cavity which shows similar properties with the native colon and is attached to the mesenteric side of the alimentary tract.It is the rarest in alimentary tract duplications.Based upon anatomic feature,colonic duplications can be classified as spherical(cystic)or tubular,with the latter being less common(approximately 20%).Symptoms of colonic duplication are dependent on the duplication site and extent,and patient age,etc.Usually,patients with colonic duplication manifest typical intestinal obstruction,potentially accompanied by recurrent dark or bright red bloody stool,varying degrees of anemia-related symptoms,and body wasting.CASE SUMMARY A young male patient was admitted to our hospital due to recurrent abdominal pain.No definite diagnosis was achieved by computed tomography(CT)or electronic colonoscopy,and the bowel preparation efficacy was suboptimal.Hirschsprung disease was suspected,and thus laparoscopic exploration was performed.An approximately 60-cm-long inverted duplicated colon with severe edema and dilation was identified.It originated from the mesenteric side of the transverse colon and ended in the terminal part of the descending colon with a blind end.The parallel native colon had a thickened colonic wall,became stiff,and was poor in peristalsis.The patient then underwent subtotal colectomy and was discharged 7 d after the surgery.From 3 mo post-surgery to date,the patient had regular bowel movement once daily and a steady increase in body weight.CONCLUSION Tubular colonic duplication is a rare type of alimentary tract duplication that can be detected by ultrasonography,CT,or magnetic resonance imaging based on the actual clinical situation.Surgical resection of aberrant colon(including the duplicated colonic segment and other potentially involved colonic segments)is the only approach to cure this medical condition.展开更多
BACKGROUNDColonic duplication is a rare congenital anomaly. Many types of heterotopic tissuewere identified within the wall of duplication. However, studies of ectopicimmature renal tissue (EIRT) involving colon dupli...BACKGROUNDColonic duplication is a rare congenital anomaly. Many types of heterotopic tissuewere identified within the wall of duplication. However, studies of ectopicimmature renal tissue (EIRT) involving colon duplication in an adult have yet tobe reported.CASE SUMMARYA 23-year-old woman visited our hospital with symptoms of recurrent abdominalpain and chronic constipation. Image analysis via abdomino-pelvic computedtomography, Gastrografin contrast study, and colonoscopy showed a blind anddilated bowel loop filled with fecal material located on the mesenteric side of thesigmoid colon. We established a diagnosis of sigmoid colon duplication anddecided to perform a laparoscopic investigation. Segmental resection of thesigmoid colon with duplication was done. Microscopically, the duplicatedsegment showed all three layers of the bowel wall and EIRT in the wall of theduplication. The postoperative period was uneventful and the patient wasdischarged nine days after the surgery without complications. She has been doingwell 12 mo after the follow-up period.CONCLUSIONA comprehensive histopathologic examination for ectopic tissues or tumors ismandatory after resection of colon duplication.展开更多
文摘BACKGROUND Alimentary tract duplication(ATD) is a rare congenital anomaly.Thus,a case of ATD with a complete colonic duplication isolated in the abdominal cavity with a fistula and multiple malformations is very distinctive.These characteristics show the variability of this disease and explain why it tends to be challenging to diagnose and treat.CASE SUMMARY A 25-year-old woman with a history of a fistula opening in her right hip since birth presented with the irregular discharge of foul fluid from the fistula and intermittent abdominal pain.Contrast-enhanced computed tomography and magnetic resonance imaging findings revealed a duplicated tube isolated in her abdominal pelvic cavity along with a pelvic malformation and double ureter.Right foot radiographic examination showed pes cavus.During surgery,the tube appeared to be an almost complete colonic structure and was verified to be connected to the fistula.All of the involved tissue and fistula were removed,and the defect in the pelvic floor was closed by suturing after surgery.After 8 mo,the postoperative follow-up has been uneventful.CONCLUSION ATD may be a differential diagnosis in sinus tract cases.Laparoscopy combined with open surgery is a viable treatment option.
文摘BACKGROUND Alimentary duplication is a rare congenital disease with a reported incidence of 1 per 4500 persons,although the exact incidence has been difficult to ascertain.According to previous reports,the most common site of duplication is the ileum,and colonic duplication is rare.Due to different types and locations of the duplication,the manifestations are varied,which makes establishing an accurate diagnosis before surgery a challenge.CASE SUMMARY A 17-year-old female patient sought evaluation in our department with constipation and chronic abdominal pain for 12 years;she had difficulty defecating and had dry stools since she was a child.An abdominal computed tomography revealed two extremely enlarged loops of bowel full of stool-like intestinal contents in the left lower abdomen,which led us to consider the possibility of colonic duplication.A laparoscopic exploration was performed,which revealed a tubular duplicated colon that shared a common opening with the transverse colon.A left hemi-colectomy was performed with a side-to-side anastomosis.The pathologic results confirmed the diagnosis.At the 6-mo followup,the patient was doing well without constipation or abdominal pain.CONCLUSION Colonic duplication is a rare alimentary abnormality in adults.Due to the nonspecific manifestations and low incidence,it is usually difficult to make an accurate diagnosis pre-operatively.Surgery is the mainstay of treatment,even though some patients are asymptomatic.
文摘BACKGROUND Colonic duplication refers to a spherical or tubular cavity which shows similar properties with the native colon and is attached to the mesenteric side of the alimentary tract.It is the rarest in alimentary tract duplications.Based upon anatomic feature,colonic duplications can be classified as spherical(cystic)or tubular,with the latter being less common(approximately 20%).Symptoms of colonic duplication are dependent on the duplication site and extent,and patient age,etc.Usually,patients with colonic duplication manifest typical intestinal obstruction,potentially accompanied by recurrent dark or bright red bloody stool,varying degrees of anemia-related symptoms,and body wasting.CASE SUMMARY A young male patient was admitted to our hospital due to recurrent abdominal pain.No definite diagnosis was achieved by computed tomography(CT)or electronic colonoscopy,and the bowel preparation efficacy was suboptimal.Hirschsprung disease was suspected,and thus laparoscopic exploration was performed.An approximately 60-cm-long inverted duplicated colon with severe edema and dilation was identified.It originated from the mesenteric side of the transverse colon and ended in the terminal part of the descending colon with a blind end.The parallel native colon had a thickened colonic wall,became stiff,and was poor in peristalsis.The patient then underwent subtotal colectomy and was discharged 7 d after the surgery.From 3 mo post-surgery to date,the patient had regular bowel movement once daily and a steady increase in body weight.CONCLUSION Tubular colonic duplication is a rare type of alimentary tract duplication that can be detected by ultrasonography,CT,or magnetic resonance imaging based on the actual clinical situation.Surgical resection of aberrant colon(including the duplicated colonic segment and other potentially involved colonic segments)is the only approach to cure this medical condition.
文摘BACKGROUNDColonic duplication is a rare congenital anomaly. Many types of heterotopic tissuewere identified within the wall of duplication. However, studies of ectopicimmature renal tissue (EIRT) involving colon duplication in an adult have yet tobe reported.CASE SUMMARYA 23-year-old woman visited our hospital with symptoms of recurrent abdominalpain and chronic constipation. Image analysis via abdomino-pelvic computedtomography, Gastrografin contrast study, and colonoscopy showed a blind anddilated bowel loop filled with fecal material located on the mesenteric side of thesigmoid colon. We established a diagnosis of sigmoid colon duplication anddecided to perform a laparoscopic investigation. Segmental resection of thesigmoid colon with duplication was done. Microscopically, the duplicatedsegment showed all three layers of the bowel wall and EIRT in the wall of theduplication. The postoperative period was uneventful and the patient wasdischarged nine days after the surgery without complications. She has been doingwell 12 mo after the follow-up period.CONCLUSIONA comprehensive histopathologic examination for ectopic tissues or tumors ismandatory after resection of colon duplication.
