Successful management of tubular colonic duplication using a laparoscopic approach: A case report and review of the literature

Abstract

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 follow-up, the patient was doing well without constipation or abdominal pain. CONCLUSION Colonic duplication is a rare alimentary abnormality in adults. Due to the non-specific 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.

Colonic duplication in an adult with chronic constipation: a case report and review of its surgical management

“…This percentage is highest in colorectal duplication than in duplication along other parts of the gastrointestinal tract. Studies have suggested that the duplicated epithelium carries a high risk of carcinogenesis [ 7 , 8 ]. Fecal matter moves more slowly through a duplicated segment, which explains the common symptoms of chronic constipation and delayed transit time.…”

“…Laparoscopic surgery was introduced in the late 20th century, but not until the turn of the century was it reported to be used for alimentary tract duplication [ 13 ]. Li et al [ 7 ] reported in their paper on all colonic duplication cases published until 2020 that laparoscopic surgery has been used in about 10% of cases from then on. The postoperative recovery was uneventful in all of those patients, who fully benefited from the advantages of laparoscopic surgery.…”

Duplication of the transverse colon in adults: a case report and literature review

“…There is a lack of unified diagnostic and treatment criteria for transverse colonic repetitive malformations. 12 cases were diagnosed using abdominal multirow CT ( 12 , 13 , 15 – 18 , 20 – 24 , 26 ), 8 cases using digitized barium enema colography ( 13 , 14 , 17 – 19 , 22 , 23 , 25 ), and colonoscopy in 4 cases ( 19 , 20 , 25 , 26 ), 8 cases using US ( 13 – 16 , 18 , 20 – 22 ) and 2 cases using plain X-ray ( 16 , 18 ). Because the symptoms of repeat transverse colon malformations in adults are mostly nonspecific, clinical diagnosis is difficult.…”