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Chronic perianal fistula: beware of rectal duplication
K L Narasimharao1, R V Patel, A K Malik
1Department of Paediatric Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Insights
A rare case of rectal duplication cyst in a child, containing ectopic duodenal tissue and pancreatic tissue, presented as a chronic perianal fistula. Surgical excision successfully removed the cyst and associated abnormal tissues.
Area of Science:
- Pediatric Surgery
- Gastrointestinal Surgery
- Congenital Anomalies
Background:
- Rectal duplication cysts are rare congenital malformations.
- Ectopic gastrointestinal and pancreatic tissues within duplications can cause complex presentations.
- Perianal fistulas in children warrant thorough investigation for underlying anomalies.
Observation:
- A pediatric patient presented with a chronic perianal fistula.
- Imaging and intraoperative findings revealed a cystic duplication of the rectum.
- The duplication contained ectopic duodenal mucosa and aberrant pancreatic tissue.
Findings:
- The rectal duplication cyst was successfully treated with subtotal excision.
- Mucosal sleeve resection from the common septum was performed.
- Histopathological examination confirmed the presence of ectopic duodenal and pancreatic tissues.
Implications:
- This case highlights the importance of considering rare congenital anomalies in pediatric perianal fistulas.
- Surgical management of rectal duplications requires careful planning to ensure complete resection.
- Understanding the composition of duplication cysts aids in predicting and managing potential complications.
Abstract:
A child with cystic duplication of the rectum containing ectopic duodenal mucosa and aberrant pancreatic tissue presenting as a chronic perianal fistula is reported. The duplication was removed by subtotal excision of the cyst along with mucosal sleeve resection from the common septum with the rectal wall.