BACKGROUND Gastrointestinal duplication is a rare congenital anomaly of the digestive tract,with colonic manifestations being particularly uncommon.Malignant transformation of colonic duplication cysts is rare,with ad...BACKGROUND Gastrointestinal duplication is a rare congenital anomaly of the digestive tract,with colonic manifestations being particularly uncommon.Malignant transformation of colonic duplication cysts is rare,with adenocarcinoma being the most frequently reported type.Herein,we report a rare case of adenocarcinoma originating from a colonic duplication cyst.CASE SUMMARY A 49-year-old woman was found to have an elevated cancer antigen 19-9 level during a routine checkup.Imaging revealed a well-defined abdominal cavity cystic mass,which was initially suspected to be an ovarian teratoma.Laparoscopic surgery revealed a duplication cyst,and pathological examination confirmed adenocarcinoma arising from the cyst.The mass within the transverse mesocolon was successfully excised by a colorectal surgeon.Immunohistochemical analysis confirmed adenocarcinoma with invasion into the muscularis propria.Postoperative endoscopy and positron emission computed tomography scan showed no signs of malignancy,except for an elevated cancer antigen 19-9 level.A multidisciplinary team recommended no further chemotherapy,advising routine follow-up for monitoring.CONCLUSION Colonic duplications,though rare,remain a differential diagnosis of unexplained abdominal masses,with complete resection being their primary treatment approach.展开更多
Gastrointestinal duplications are an uncommon congenital abnormality that manifest before the age of two in 80% of cases. Ileal duplication is the most common while colonic duplication, either cystic or tubular, occur...Gastrointestinal duplications are an uncommon congenital abnormality that manifest before the age of two in 80% of cases. Ileal duplication is the most common while colonic duplication, either cystic or tubular, occurs in 10%-15% of cases and remains asymptomatic and undiagnosed in most cases. Mostly occurring in pediatric patients, colonic duplication is encountered in adults in only a few cases. The most common clinical manifestations are abdominal pain and intestinal obstruction. Rarely, duplications present with signs of acute abdomen or acute bleeding. This study reports a case of colonic duplication in an adult who presented with chronic constipation. Complete diagnostic workup was made on several occasions during the previous eight year period, but no pathology was found and chronic constipation was attributed to hypothyroidism caused by long standing Hashimoto thyroiditis. Nultislice CT, performed because of abdominal distension, defined colonic pathology but the definite diagnosis of duplication of the transversal colon was made at operation. The cystic duplication and the adjacent part of the ascending and transversal colon were excised enblock. This study implies that colonic duplication, though uncommon, should be included in the differential diagnosis of chronic constipation even when precipitating factors for constipation, such as hypothyroidism are present.展开更多
Gastrointestinal duplication is an uncommon congenital abnormality in two-thirds of cases manifesting before the age of 2 years. Ileal duplication is common while colonic duplication, either cystic or tubular, is a ra...Gastrointestinal duplication is an uncommon congenital abnormality in two-thirds of cases manifesting before the age of 2 years. Ileal duplication is common while colonic duplication, either cystic or tubular, is a rather unusual clinical entity that remains asymptomatic and undiagnosed in most cases. Mostly occurring in pediatric patients,colonic duplication is encountered in adults only in a few cases. This study reports two cases of colonic duplication in adults. Both cases presented with rectal bleeding on admission. The study was focused on clinical, imaging,histological, and therapeutical aspects of the presenting cases. Gastrografin enema established the diagnosis in both cases. The cystic structure and the adjacent part of the colon were excised en-block. The study implies that colonic duplication, though uncommon, should be included in the differential diagnosis of rectal bleeding.展开更多
BACKGROUND Alimentary tract duplication(ATD) is a rare congenital anomaly.Thus,a case of ATD with a complete colonic duplication isolated in the abdominal cavity with a fistula and multiple malformations is very disti...BACKGROUND Alimentary tract duplication(ATD) is a rare congenital anomaly.Thus,a case of ATD with a complete colonic duplication isolated in the abdominal cavity with a fistula and multiple malformations is very distinctive.These characteristics show the variability of this disease and explain why it tends to be challenging to diagnose and treat.CASE SUMMARY A 25-year-old woman with a history of a fistula opening in her right hip since birth presented with the irregular discharge of foul fluid from the fistula and intermittent abdominal pain.Contrast-enhanced computed tomography and magnetic resonance imaging findings revealed a duplicated tube isolated in her abdominal pelvic cavity along with a pelvic malformation and double ureter.Right foot radiographic examination showed pes cavus.During surgery,the tube appeared to be an almost complete colonic structure and was verified to be connected to the fistula.All of the involved tissue and fistula were removed,and the defect in the pelvic floor was closed by suturing after surgery.After 8 mo,the postoperative follow-up has been uneventful.CONCLUSION ATD may be a differential diagnosis in sinus tract cases.Laparoscopy combined with open surgery is a viable treatment option.展开更多
BACKGROUND Alimentary duplication is a rare congenital disease with a reported incidence of 1 per 4500 persons,although the exact incidence has been difficult to ascertain.According to previous reports,the most common...BACKGROUND Alimentary duplication is a rare congenital disease with a reported incidence of 1 per 4500 persons,although the exact incidence has been difficult to ascertain.According to previous reports,the most common site of duplication is the ileum,and colonic duplication is rare.Due to different types and locations of the duplication,the manifestations are varied,which makes establishing an accurate diagnosis before surgery a challenge.CASE SUMMARY A 17-year-old female patient sought evaluation in our department with constipation and chronic abdominal pain for 12 years;she had difficulty defecating and had dry stools since she was a child.An abdominal computed tomography revealed two extremely enlarged loops of bowel full of stool-like intestinal contents in the left lower abdomen,which led us to consider the possibility of colonic duplication.A laparoscopic exploration was performed,which revealed a tubular duplicated colon that shared a common opening with the transverse colon.A left hemi-colectomy was performed with a side-to-side anastomosis.The pathologic results confirmed the diagnosis.At the 6-mo followup,the patient was doing well without constipation or abdominal pain.CONCLUSION Colonic duplication is a rare alimentary abnormality in adults.Due to the nonspecific manifestations and low incidence,it is usually difficult to make an accurate diagnosis pre-operatively.Surgery is the mainstay of treatment,even though some patients are asymptomatic.展开更多
BACKGROUND Colonic duplication refers to a spherical or tubular cavity which shows similar properties with the native colon and is attached to the mesenteric side of the alimentary tract.It is the rarest in alimentary...BACKGROUND Colonic duplication refers to a spherical or tubular cavity which shows similar properties with the native colon and is attached to the mesenteric side of the alimentary tract.It is the rarest in alimentary tract duplications.Based upon anatomic feature,colonic duplications can be classified as spherical(cystic)or tubular,with the latter being less common(approximately 20%).Symptoms of colonic duplication are dependent on the duplication site and extent,and patient age,etc.Usually,patients with colonic duplication manifest typical intestinal obstruction,potentially accompanied by recurrent dark or bright red bloody stool,varying degrees of anemia-related symptoms,and body wasting.CASE SUMMARY A young male patient was admitted to our hospital due to recurrent abdominal pain.No definite diagnosis was achieved by computed tomography(CT)or electronic colonoscopy,and the bowel preparation efficacy was suboptimal.Hirschsprung disease was suspected,and thus laparoscopic exploration was performed.An approximately 60-cm-long inverted duplicated colon with severe edema and dilation was identified.It originated from the mesenteric side of the transverse colon and ended in the terminal part of the descending colon with a blind end.The parallel native colon had a thickened colonic wall,became stiff,and was poor in peristalsis.The patient then underwent subtotal colectomy and was discharged 7 d after the surgery.From 3 mo post-surgery to date,the patient had regular bowel movement once daily and a steady increase in body weight.CONCLUSION Tubular colonic duplication is a rare type of alimentary tract duplication that can be detected by ultrasonography,CT,or magnetic resonance imaging based on the actual clinical situation.Surgical resection of aberrant colon(including the duplicated colonic segment and other potentially involved colonic segments)is the only approach to cure this medical condition.展开更多
Colonic intussusception and gastrointestinal duplication are diseases that arise in young children. The clinical presentation of adult cases of intussusception and enteric duplication is non-specific and thus poses a ...Colonic intussusception and gastrointestinal duplication are diseases that arise in young children. The clinical presentation of adult cases of intussusception and enteric duplication is non-specific and thus poses a diagnostic challenge. A computed tomography (CT) scan is recommended in adult cases as the most sensitive diagnostic tool and the pathognomonic finding of outer intussuscepiens and central intussusceptum is diagnostic. A septum of a duplicated colon in a non-intussuscepted segment has been rarely reported in the literature. With advancements in radiological imaging technology and the increased availability of CT scanners, the capacity for a correct pre-operative diagnosis has been significantly enhanced. Our current case report illustrates the importance of considering an uncommon etiology for enteric intussusception and duplication as a differential diagnosis of acute abdomen in an adult patient. Our analyses of this patient also highlight the successful use of CT scanning to make this diagnosis.展开更多
Gastrointestinal duplication is an uncommon congenital abnormality, and colonic duplication combined with teratoma has rarely been reported. A 24-year-old man presented to the Emergency Department with a sudden onset ...Gastrointestinal duplication is an uncommon congenital abnormality, and colonic duplication combined with teratoma has rarely been reported. A 24-year-old man presented to the Emergency Department with a sudden onset of severe abdominal pain lasting 2 hours without intermission, and also complained to have who had chronic constipation since his birth.Multislice CT imaging showed 2 masses in the retroperitoneal space. The one huge cystic mass was detected behind the transverse colon, pancrease and stomach without infiltration into the surrounding tissues. The right mass containing soft tissues and bones pushed aside the inferior vena cava and right kidney.The cystic duplication and the right mass were excised separately.This case indicates that a patient diagnosed as colonic duplication should receive further differential diagnosis to identify if it coexists other diseases, espedally the teratoma.展开更多
Combined duplication of the colon and vermiform appendix is one of the rare congenital anomalities of the alimentary tract. Only a few cases have been reported in the adult population. A 28-year-old man presented to t...Combined duplication of the colon and vermiform appendix is one of the rare congenital anomalities of the alimentary tract. Only a few cases have been reported in the adult population. A 28-year-old man presented to the clinic with a mass in the right flank. Imaging showed only a hydronephrotic atrophic kidney. The f inal diagnosis was only available at exploration. Combined duplication of the tubular colon and vermiform appendix was conf irmed histopathologically. The patient was treated with nephrectomy and complete resection of the duplicated colon and vermiform appendix. The patient recovered uneventfully,and has done well for the past year. This is believed to be one of the first reports of combined duplication of the tubular colon and vermiform appendix as a cause of hydronephrotic atrophic kidney in an adult patient.展开更多
BACKGROUNDColonic duplication is a rare congenital anomaly. Many types of heterotopic tissuewere identified within the wall of duplication. However, studies of ectopicimmature renal tissue (EIRT) involving colon dupli...BACKGROUNDColonic duplication is a rare congenital anomaly. Many types of heterotopic tissuewere identified within the wall of duplication. However, studies of ectopicimmature renal tissue (EIRT) involving colon duplication in an adult have yet tobe reported.CASE SUMMARYA 23-year-old woman visited our hospital with symptoms of recurrent abdominalpain and chronic constipation. Image analysis via abdomino-pelvic computedtomography, Gastrografin contrast study, and colonoscopy showed a blind anddilated bowel loop filled with fecal material located on the mesenteric side of thesigmoid colon. We established a diagnosis of sigmoid colon duplication anddecided to perform a laparoscopic investigation. Segmental resection of thesigmoid colon with duplication was done. Microscopically, the duplicatedsegment showed all three layers of the bowel wall and EIRT in the wall of theduplication. The postoperative period was uneventful and the patient wasdischarged nine days after the surgery without complications. She has been doingwell 12 mo after the follow-up period.CONCLUSIONA comprehensive histopathologic examination for ectopic tissues or tumors ismandatory after resection of colon duplication.展开更多
基金Supported by a research fund from Dankook University in 2024this research was supported by the Bio&Medical Technology Development Program of the National Research Foundation(NRF)funded by the Korean government(MSIT)(RS-2023-00220408).
文摘BACKGROUND Gastrointestinal duplication is a rare congenital anomaly of the digestive tract,with colonic manifestations being particularly uncommon.Malignant transformation of colonic duplication cysts is rare,with adenocarcinoma being the most frequently reported type.Herein,we report a rare case of adenocarcinoma originating from a colonic duplication cyst.CASE SUMMARY A 49-year-old woman was found to have an elevated cancer antigen 19-9 level during a routine checkup.Imaging revealed a well-defined abdominal cavity cystic mass,which was initially suspected to be an ovarian teratoma.Laparoscopic surgery revealed a duplication cyst,and pathological examination confirmed adenocarcinoma arising from the cyst.The mass within the transverse mesocolon was successfully excised by a colorectal surgeon.Immunohistochemical analysis confirmed adenocarcinoma with invasion into the muscularis propria.Postoperative endoscopy and positron emission computed tomography scan showed no signs of malignancy,except for an elevated cancer antigen 19-9 level.A multidisciplinary team recommended no further chemotherapy,advising routine follow-up for monitoring.CONCLUSION Colonic duplications,though rare,remain a differential diagnosis of unexplained abdominal masses,with complete resection being their primary treatment approach.
文摘Gastrointestinal duplications are an uncommon congenital abnormality that manifest before the age of two in 80% of cases. Ileal duplication is the most common while colonic duplication, either cystic or tubular, occurs in 10%-15% of cases and remains asymptomatic and undiagnosed in most cases. Mostly occurring in pediatric patients, colonic duplication is encountered in adults in only a few cases. The most common clinical manifestations are abdominal pain and intestinal obstruction. Rarely, duplications present with signs of acute abdomen or acute bleeding. This study reports a case of colonic duplication in an adult who presented with chronic constipation. Complete diagnostic workup was made on several occasions during the previous eight year period, but no pathology was found and chronic constipation was attributed to hypothyroidism caused by long standing Hashimoto thyroiditis. Nultislice CT, performed because of abdominal distension, defined colonic pathology but the definite diagnosis of duplication of the transversal colon was made at operation. The cystic duplication and the adjacent part of the ascending and transversal colon were excised enblock. This study implies that colonic duplication, though uncommon, should be included in the differential diagnosis of chronic constipation even when precipitating factors for constipation, such as hypothyroidism are present.
文摘Gastrointestinal duplication is an uncommon congenital abnormality in two-thirds of cases manifesting before the age of 2 years. Ileal duplication is common while colonic duplication, either cystic or tubular, is a rather unusual clinical entity that remains asymptomatic and undiagnosed in most cases. Mostly occurring in pediatric patients,colonic duplication is encountered in adults only in a few cases. This study reports two cases of colonic duplication in adults. Both cases presented with rectal bleeding on admission. The study was focused on clinical, imaging,histological, and therapeutical aspects of the presenting cases. Gastrografin enema established the diagnosis in both cases. The cystic structure and the adjacent part of the colon were excised en-block. The study implies that colonic duplication, though uncommon, should be included in the differential diagnosis of rectal bleeding.
文摘BACKGROUND Alimentary tract duplication(ATD) is a rare congenital anomaly.Thus,a case of ATD with a complete colonic duplication isolated in the abdominal cavity with a fistula and multiple malformations is very distinctive.These characteristics show the variability of this disease and explain why it tends to be challenging to diagnose and treat.CASE SUMMARY A 25-year-old woman with a history of a fistula opening in her right hip since birth presented with the irregular discharge of foul fluid from the fistula and intermittent abdominal pain.Contrast-enhanced computed tomography and magnetic resonance imaging findings revealed a duplicated tube isolated in her abdominal pelvic cavity along with a pelvic malformation and double ureter.Right foot radiographic examination showed pes cavus.During surgery,the tube appeared to be an almost complete colonic structure and was verified to be connected to the fistula.All of the involved tissue and fistula were removed,and the defect in the pelvic floor was closed by suturing after surgery.After 8 mo,the postoperative follow-up has been uneventful.CONCLUSION ATD may be a differential diagnosis in sinus tract cases.Laparoscopy combined with open surgery is a viable treatment option.
文摘BACKGROUND Alimentary duplication is a rare congenital disease with a reported incidence of 1 per 4500 persons,although the exact incidence has been difficult to ascertain.According to previous reports,the most common site of duplication is the ileum,and colonic duplication is rare.Due to different types and locations of the duplication,the manifestations are varied,which makes establishing an accurate diagnosis before surgery a challenge.CASE SUMMARY A 17-year-old female patient sought evaluation in our department with constipation and chronic abdominal pain for 12 years;she had difficulty defecating and had dry stools since she was a child.An abdominal computed tomography revealed two extremely enlarged loops of bowel full of stool-like intestinal contents in the left lower abdomen,which led us to consider the possibility of colonic duplication.A laparoscopic exploration was performed,which revealed a tubular duplicated colon that shared a common opening with the transverse colon.A left hemi-colectomy was performed with a side-to-side anastomosis.The pathologic results confirmed the diagnosis.At the 6-mo followup,the patient was doing well without constipation or abdominal pain.CONCLUSION Colonic duplication is a rare alimentary abnormality in adults.Due to the nonspecific manifestations and low incidence,it is usually difficult to make an accurate diagnosis pre-operatively.Surgery is the mainstay of treatment,even though some patients are asymptomatic.
文摘BACKGROUND Colonic duplication refers to a spherical or tubular cavity which shows similar properties with the native colon and is attached to the mesenteric side of the alimentary tract.It is the rarest in alimentary tract duplications.Based upon anatomic feature,colonic duplications can be classified as spherical(cystic)or tubular,with the latter being less common(approximately 20%).Symptoms of colonic duplication are dependent on the duplication site and extent,and patient age,etc.Usually,patients with colonic duplication manifest typical intestinal obstruction,potentially accompanied by recurrent dark or bright red bloody stool,varying degrees of anemia-related symptoms,and body wasting.CASE SUMMARY A young male patient was admitted to our hospital due to recurrent abdominal pain.No definite diagnosis was achieved by computed tomography(CT)or electronic colonoscopy,and the bowel preparation efficacy was suboptimal.Hirschsprung disease was suspected,and thus laparoscopic exploration was performed.An approximately 60-cm-long inverted duplicated colon with severe edema and dilation was identified.It originated from the mesenteric side of the transverse colon and ended in the terminal part of the descending colon with a blind end.The parallel native colon had a thickened colonic wall,became stiff,and was poor in peristalsis.The patient then underwent subtotal colectomy and was discharged 7 d after the surgery.From 3 mo post-surgery to date,the patient had regular bowel movement once daily and a steady increase in body weight.CONCLUSION Tubular colonic duplication is a rare type of alimentary tract duplication that can be detected by ultrasonography,CT,or magnetic resonance imaging based on the actual clinical situation.Surgical resection of aberrant colon(including the duplicated colonic segment and other potentially involved colonic segments)is the only approach to cure this medical condition.
文摘Colonic intussusception and gastrointestinal duplication are diseases that arise in young children. The clinical presentation of adult cases of intussusception and enteric duplication is non-specific and thus poses a diagnostic challenge. A computed tomography (CT) scan is recommended in adult cases as the most sensitive diagnostic tool and the pathognomonic finding of outer intussuscepiens and central intussusceptum is diagnostic. A septum of a duplicated colon in a non-intussuscepted segment has been rarely reported in the literature. With advancements in radiological imaging technology and the increased availability of CT scanners, the capacity for a correct pre-operative diagnosis has been significantly enhanced. Our current case report illustrates the importance of considering an uncommon etiology for enteric intussusception and duplication as a differential diagnosis of acute abdomen in an adult patient. Our analyses of this patient also highlight the successful use of CT scanning to make this diagnosis.
文摘Gastrointestinal duplication is an uncommon congenital abnormality, and colonic duplication combined with teratoma has rarely been reported. A 24-year-old man presented to the Emergency Department with a sudden onset of severe abdominal pain lasting 2 hours without intermission, and also complained to have who had chronic constipation since his birth.Multislice CT imaging showed 2 masses in the retroperitoneal space. The one huge cystic mass was detected behind the transverse colon, pancrease and stomach without infiltration into the surrounding tissues. The right mass containing soft tissues and bones pushed aside the inferior vena cava and right kidney.The cystic duplication and the right mass were excised separately.This case indicates that a patient diagnosed as colonic duplication should receive further differential diagnosis to identify if it coexists other diseases, espedally the teratoma.
文摘Combined duplication of the colon and vermiform appendix is one of the rare congenital anomalities of the alimentary tract. Only a few cases have been reported in the adult population. A 28-year-old man presented to the clinic with a mass in the right flank. Imaging showed only a hydronephrotic atrophic kidney. The f inal diagnosis was only available at exploration. Combined duplication of the tubular colon and vermiform appendix was conf irmed histopathologically. The patient was treated with nephrectomy and complete resection of the duplicated colon and vermiform appendix. The patient recovered uneventfully,and has done well for the past year. This is believed to be one of the first reports of combined duplication of the tubular colon and vermiform appendix as a cause of hydronephrotic atrophic kidney in an adult patient.
文摘BACKGROUNDColonic duplication is a rare congenital anomaly. Many types of heterotopic tissuewere identified within the wall of duplication. However, studies of ectopicimmature renal tissue (EIRT) involving colon duplication in an adult have yet tobe reported.CASE SUMMARYA 23-year-old woman visited our hospital with symptoms of recurrent abdominalpain and chronic constipation. Image analysis via abdomino-pelvic computedtomography, Gastrografin contrast study, and colonoscopy showed a blind anddilated bowel loop filled with fecal material located on the mesenteric side of thesigmoid colon. We established a diagnosis of sigmoid colon duplication anddecided to perform a laparoscopic investigation. Segmental resection of thesigmoid colon with duplication was done. Microscopically, the duplicatedsegment showed all three layers of the bowel wall and EIRT in the wall of theduplication. The postoperative period was uneventful and the patient wasdischarged nine days after the surgery without complications. She has been doingwell 12 mo after the follow-up period.CONCLUSIONA comprehensive histopathologic examination for ectopic tissues or tumors ismandatory after resection of colon duplication.
