From July 1998 to December 2000, the distribution of pulmonary blood flow was evaluated in 34 consecutive surviving patients who had been randomly assigned to one of 4 different modes of total cavopulmonary connection. All patients underwent radionuclide lung perfusion imaging with 99m Tc-macroaggregated albumin to determine the distribution of blood from the superior and inferior venae cavae and the total pulmonary flow to each lung. The most physiological distribution of blood between the right and left lungs was obtained when the inferior vena cava anastomosis was widened and slightly offset towards the right pulmonary artery in patients without persistent left superior vena cava. This type of anastomosis should also reduce the incidence of arteriovenous malformations in the lung caused by exclusion of hepatic venous return.

Gastrointestinal duplication is an uncommon congenital abnormality, and colonic duplication combined with teratoma has rarely been reported. A 24-year-old man presented to the Emergency Department with a sudden onset of severe abdominal pain lasting 2 hours without intermission, and also complained to have who had chronic constipation since his birth. Multislice CT imaging showed 2 masses in the retroperitoneal space. The one huge cystic mass was detected behind the transverse colon, pancrease and stomach without infi ltration into the surrounding tissues. The right mass containing soft tissues and bones pushed aside the inferior vena cava and right kidney. The cystic duplication and the right mass were excised separately. This case indicates that a patient diagnosed as colonic duplication should receive further differential diagnosis to identify if it coexists other diseases, especially the teratoma.