Sigmoid colon duplication associated with urogenital malformations: A rare case report

Sigmoid colon duplication is a rare congenital anomaly, particularly when associated with complex urogenital malformations such as bladder and urethral duplication. These anomalies present significant diagnostic and surgical challenges. We previously reported this patient's case focusing on her genitourinary anomalies. During follow-up, the patient developed symptoms that led to the diagnosis of an undetected sigmoid colon duplication with a fistulous connection to the vagina, necessitating further surgical intervention.

A female neonate was diagnosed with bladder exstrophy, urethral and bladder duplication and ambiguous genitalia at birth. At 7 months of age, she developed intermittent fecal discharge through the vagina, initially suspected to be a rectovaginal fistula. Imaging studies, including contrast-enhanced CT, revealed a duplicated sigmoid colon with a fistulous connection to the vagina. At 3 years old, she underwent laparotomy, which confirmed two sigmoid segments sharing a common mesentery. The anterior duplicated segment forming the fistula, was surgically resected, and the fistula was closed, THE patient had an uneventful postoperative recovery, with resolution of symptoms.

Sigmoid colon duplication is a rare entity that can remain undiagnosed for years. It may present with diverse symptoms, including obstruction, infection, or fistulization to adjacent organs. The association with bladder and urethral duplication suggest a possible common embryological origin. Accurate diagnosis requires advanced imaging techniques, particularly contrast studies from multiple entry points. Surgical intervention is the treatment of choice, aiming to remove the non-functional duplicated segment while preserving bowel integrity.

This case highlights the importance of long-term follow-up in patients with complex congenital anomalies. Sigmoid colon duplication should be considered in cases of unexplained vaginal fecal discharge, particularly in individuals with associated urogenital malformations. Early recognition for preventing and surgical treatment are crucial for preventing complications and improving patient outcomes.