Complete colonic duplication in children.

Area of Science:

• Pediatric Surgery
• Congenital Anomalies
• Gastrointestinal Malformations

Background:

• Complete colonic duplication is an exceptionally rare congenital anomaly, accounting for approximately 15% of all gastrointestinal duplications.
• Presentation varies significantly based on the location and size of the duplication.
• This report details two distinct cases of complete colonic duplication.

Observation:

• Case 1: A 2-year-old boy presented with abdominal distension, defecation difficulties, chronic constipation, and a rectocele since 6 months of age. Imaging revealed a palpable pelvic mass.
• Case 2: A 2-day-old infant had imperforate anus, recto-sigmoid duplication, diphallus, double bladder, and hypospadias, indicating complex associated anomalies.
• Both patients underwent surgical management tailored to their specific conditions.

Findings:

• Case 1 was treated with simple fenestration of a total tubular colorectal duplication, resulting in normal defecation and weight gain post-operatively.
• Case 2 required staged surgical interventions for complex congenital anomalies, leading to a normal life after four years of follow-up.
• Successful management highlights the importance of individualized surgical approaches.

Implications:

• Complete colonic duplication necessitates thorough systemic evaluation due to frequent co-occurrence of other congenital anomalies.
• Surgical strategies, including resection, fenestration, and correction of associated anomalies, are crucial for optimal patient outcomes.
• Prompt diagnosis and management are vital for improving the quality of life in affected children.