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. 2021 Jul-Sep;62(3):751-756.
doi: 10.47162/RJME.62.3.12.

Alimentary tract duplications in children - a 15 years' experience

Radu Iulian Spătaru  1 , Mircea Ovidiu Denis Lupuşoru, Dragoş Şerban, Monica Ivanov, Dan Alexandru Iozsa
Affiliations

Alimentary tract duplications in children - a 15 years' experience

Radu Iulian Spătaru et al. Rom J Morphol Embryol. 2021 Jul-Sep.

Abstract

Duplications of the alimentary tract are a diverse and complex spectrum of congenital malformations and can be found anywhere along the digestive tract. The management depends on multiple factors, such as age, location, size, macroscopic aspect, and the associated anomalies. This study reflects a 15-year single surgical team experience. We reviewed medical records of 35 consecutive patients presenting alimentary tract duplications, evaluated and managed between 2004 and 2019. The anatomical distribution included: oral structures (two cases), esophageal (three cases), gastric (three patients), jejunoileal (seven cases), ileocecal (12 cases), colonic (six cases), anorectal (one case), and one case of complex tubular duplication of the terminal ileum and entire colon with two anal openings at the perineum. Four patients had antenatal diagnosis, initially asymptomatic, were followed, after birth, with repeated ultrasound examinations for a medium period of 3.8 months. All cases were managed with open surgery. Excision of the lesion with preservation of the gut integrity could be performed in 28 of the cases, while in six cases, enterectomy followed by digestive anastomosis was required. In one complex caudal duplication syndrome, the duplicated tubular colon was left in place. The postoperative complications were gastroesophageal reflux disease (GERD) (two cases), Claude Bernard-Horner syndrome (one case), wound infection (one case), and in one case, massive tongue edema. Clinical findings may be misleading, imaging studies may be uncertain, therefore the surgeon remains to complete de picture with intraoperative findings. In complex duplication cases, a multidisciplinary approach is imperative for the best results.

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Conflict of interest statement

The authors declare that they have no conflict of interests.

Figures

Figure 1
Figure 1
Cystic duplication of ileum (A), colon (B), and ileocecum (C)
Figure 2
Figure 2
Tongue duplication associated with incomplete duplication of mandible: (A) Preoperative aspect at birth; (B) Postoperative follow-up at 2 years old
Figure 3
Figure 3
(A) Thoracic cystic esophageal duplication, MRI aspect; (B) Intraoperative image of a cervical esophageal duplication. MRI: Magnetic resonance imaging
Figure 4
Figure 4
MRI aspect of a gastric duplication extended into lower thorax. MRI: Magnetic resonance imaging
Figure 5
Figure 5
Duplication of the terminal ileum and appendix (A), and complete colon duplication (B)
See this image and copyright information in PMC

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