Related Experiment Video
Updated: Oct 5, 2026
Intrathecal Application of a Fluorescent Dye for the Identification of Cerebrospinal Fluid Leaks in Cochlear Malformation
Published on: February 29, 2020
Anal canal duplication in infants and children--a series of 6 cases
C Jacquier1, E Dobremez, C Piolat
1Service de Chirurgie Pédiatrique, Hĵpital Albert Michallon, Centre Hospitalier et Universitaire de Grenoble, France.
Insights
Anal canal duplications (ACD) are rare congenital anomalies. Early diagnosis through perineal inspection and imaging, followed by surgical excision, ensures favorable outcomes and prevents long-term complications.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Congenital Anomalies
Background:
- Anal canal duplications (ACD) are uncommon congenital malformations of the alimentary tract.
- These duplications are typically located posteriorly to the anal canal, presenting with a perineal opening.
- Associated anomalies, such as presacral tumors and anorectal malformations, are frequently observed.
Observation:
- Six cases of ACD are presented, with five diagnosed in infants under one year old via perineal inspection.
- Symptoms ranged from asymptomatic presentation to anal pain, perineal pain, and diarrhea in an older child.
- Imaging modalities like fistulography revealed tubular or cystic structures, with one case showing communication with the anal canal.
Findings:
- Five cases were surgically excised via a perineal approach.
- One case required a combined sacral and perineal approach due to an associated teratoma.
- Preoperative investigations including pelvic X-ray, ultrasound, barium enema, and fistulography were sufficient for diagnosis.
Implications:
- Early diagnosis and surgical intervention are crucial for preventing complications like infection, bleeding, and malignant changes.
- Non-invasive imaging modalities are generally adequate for diagnosis, reserving MRI for specific indications.
- Management and prognosis are influenced by associated anomalies, necessitating a tailored surgical approach.
Abstract:
The authors present a series of six anal canal duplications (ACD), duplications of the alimentary tract located along the posterior side of the anal canal, with a perineal opening just behind the anus. Five asymptomatic duplications were diagnosed before the age of one year, by simple perineal inspection. A twelve-year-old girl presented with perineal and anal pains and diarrhoea. Fistulography revealed a tubular structure in five cases and a cystic structure in one case, behind the normal anal canal, in one case communicating with it. A presacral sacrococcygeal teratoma was found in two children and in one case it was visualised by preoperative US in an infant with a lumbosacral myelomeningocele. Surgical excision was performed by a perineal approach in 5 cases, by a combined sacral and perineal approach in the last case, because of the associated teratoma. Non-invasive preoperative investigations, consisting of a pelvic X-ray, US examination, barium enema and fistulography, are sufficient in most cases; MRI is reserved for special indications. Surgical treatment restores a normal perineal aspect, without sequelae, and avoids complications like those described in other types of digestive duplications: infection, ulceration, bleeding, malignant changes during later adult life. Associated anomalies are frequently described in the literature, especially presacral tumours (16%) and anorectal malformations (21%); they can influence the management, the surgical approach and the functional prognosis.
