Management of total colonic duplication: retrospective single institution Chinese study

To summarize the clinical features and surgical treatments of patients with total colonic duplication (TCD).

Clinical data on 7 TCD patients who underwent surgical treatments at Beijing Children's Hospital from January 2010 to December 2024 was retrospectively collected and analyzed, including clinical presentations, surgical details, and prognosis.

Of the 7 patients, 4 (57%) were female. In addition to 1 patient whose prenatal ultrasound revealed abnormalities, abnormalities were found in all patients after birth, including 3 passing meconium through the fossa vestibuli vaginae, 2 with constipation/vomiting, 1 with cloaca, and 1 passing meconium through the urethra. Of the 7 patients, 2 were accurately diagnosed and treated in time (the patient with cloaca who underwent colostomy and the patient who was examined in our outpatient department after birth), and 5 (71%) were not. The average age at hospitalization was 14 (6-138) months. Before hospitalization, 4 patients (57%) experienced rectal mass prolapse during defecation. All patients underwent laparotomy, including 5 undergoing the "distal cross-section, mucosa stripping and closure" procedure, 1 resection of the distal duplicated colon with the proximal end closed and ileostomy, and 1 Soave procedure and ileostomy. All patients recovered well without fecal incontinence except for the patient with cloaca who defecated more than 3 times per day.

In addition to abnormalities after birth, rectal mass prolapse may be a specific presentation of TCD. The aim of surgery for TCD is to connect the duplicated and native colon and ligate the fistula.