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Rectal duplications.

M P La Quaglia1, N Feins, A Eraklis

  • 1Department of Surgery, Children's Hospital Medical Center, Boston, MA.

Journal of Pediatric Surgery
|September 1, 1990
PubMed
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Rectal duplications are rare congenital anomalies often misdiagnosed as common anorectal conditions, delaying treatment. Surgical excision, regardless of approach, offers a curative solution with normal postoperative continence.

Area of Science:

  • Pediatric Surgery
  • Gastroenterology
  • Congenital Anomalies

Background:

  • Rectal duplications are rare congenital anomalies.
  • They are frequently misdiagnosed as hemorrhoids or fistula-in-ano, leading to delayed diagnosis and treatment.
  • This can result in complications such as infection within the duplication.

Purpose of the Study:

  • To review the clinical presentation, diagnostic challenges, and surgical management of rectal duplications.
  • To highlight the importance of considering rectal duplication in the differential diagnosis of pediatric anorectal pathology.
  • To evaluate the efficacy and outcomes of different surgical approaches.

Main Methods:

  • Retrospective review of 11 cases of rectal duplication.
  • Analysis of patient demographics, presenting signs and symptoms, diagnostic methods, and surgical interventions.

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  • Evaluation of postoperative outcomes, including continence.

    • Main Results:

    • Patients presented between newborn and 18 years (mean 17 months).
    • Common presentations included perianal/anal fistula (5 cases), obstruction/prolapse (3 cases), and rectal bleeding (3 cases).
    • No spinal or vertebral anomalies were noted. All patients achieved normal postoperative continence after total excision via transanal, postanal, or posterior sagittal approaches.

    Conclusions:

    • Rectal duplications can mimic common anorectal conditions, necessitating a high index of suspicion.
    • Early and accurate diagnosis is crucial for timely intervention.
    • Total surgical excision using various posterior approaches is curative and preserves normal continence.