A rare case of duplication of the descending colon in a pregnant woman: case report and literature review

Vittorio Cherchi; Sergio Intini; Jaqueline Velkoski; Sergio Calandra; Marco Ventin; Monica Della Martina; Dario Lorenzin; Lorenza Driul; Giovanni Terrosu

doi:10.23750/abm.v94iS1.12169

A rare case of duplication of the descending colon in a pregnant woman: case report and literature review

Authors

Vittorio Cherchi a:1:{s:5:"en_US";s:81:"University Hospital of Udine - General Surgery Clinic and Liver Transplant Center";}
Sergio Intini General Surgery Clinic and Liver Transplant Center, University Hospital of Udine, Udine, Italy
Jaqueline Velkoski General Surgery Clinic and Liver Transplant Center, University Hospital of Udine, Udine, Italy
Sergio Calandra General Surgery Clinic and Liver Transplant Center, University Hospital of Udine, Udine, Italy
Marco Ventin Department of Medical Area (DAME), University of Udine, Udine, Italy
Monica Della Martina Clinic of Obstetrics and Gynecology, University Hospital of Udine, Udine, Italy
Dario Lorenzin General Surgery Clinic and Liver Transplant Center, University Hospital of Udine, Udine, Italy
Lorenza Driul Clinic of Obstetrics and Gynecology, University Hospital of Udine, Udine, Italy
Giovanni Terrosu General Surgery Clinic and Liver Transplant Center, University Hospital of Udine, Udine, Italy

DOI: https://doi.org/10.23750/abm.v94iS1.12169

Keywords:

intestinal duplication; colonic duplication;, acute abdomen; pregnancy;, caesarean birth

Abstract

Introduction: Gastrointestinal duplications are uncommon congenital abnormalities that can occur anywhere throughout the intestinal tract. The small bowel is more interested than the large one. Duplications are schematically classified as spherical and tubular, respectively representing 80% and 20% of cases, with different relationships and communications with the native intestinal wall. Although typically diagnosed during infancy and early childhood, tubular colonic sub-type stays frequently hidden for several years until a complication occurs.

Case presentation: we report the case of a T-shaped tubular duplication in a 20-year-old woman at the 30^th week of gestation, who underwent an urgent exploratory laparotomy for intestinal occlusion, treated with the resection of the aberrant large bowel. The patient was notable for a long history of constipation and chronic pain. Diagnostic possibilities were limited by the on-going pregnancy.

Conclusion: Intestinal duplications are uncommon malformations, and, of these, the T-shaped subtype of the colon is among the rarest ones. In the adulthood, diagnosis is usually established in the operating room during urgent or even emergency surgery performed for abdominal complications. A duplication of the descending colon is extremely rare, and this is, to our knowledge, the only article describing a case found in advanced state of pregnancy.

References

Puligandla PS, Nguyen LT, St-Vil D, Flageole H, Bensoussan AL, Nguyen VH et al. Gastrointestinal duplications. J Pediatric Surg. 2003; 38: 740-744.

Kekez T, Augustin G, Hrstic I, Smud D, Majerovic M, Jelincic Z et al. Colonic duplication in an adult who presented with chronic constipation attributed to hypothyroidism. Worl J Gastroenterol. 2008; 14: 644-6.

Mourra N, Chafai N, Bessoud B, Reveri V, Werbrouck A, Tiret E. Colorectal duplication in adults: report of seven cases. J Clin Pathol. 2010; 63: 1080-3.

Kaur N, Nagpal K, Sodhi P, Minocha VR. Hindgut duplication-case report and literature review. Pediatr Surg Int. 2004; 20: 640-2.

Gross RE, Holocomb GW Jr, Farber S. Duplications of the alimentary tract. Pediatrics. Apr 1952; 9 (4): 448-68.

Kottra J, Dodds WJ. Duplication of large bowel. AJR Am J Roentenol. 1971; 113: 310-5.

Smith ED. Duplication of the anus and genitourinary tract. Surgery. 1969; 66: 909-21.

Shah KR, Joshi A. Complete Genitourinary and Colonic Duplication. J Ultrasound Med. 2006; 25: 407-11.

McPherson AG, Trapnell JE, Airth GR. Duplication of the. Duplication of the colon. Br J Surg. 1969; 56: 138-42.

Correia-Pinto J, Romero R, Carvalho JL, Silva G,. Neonatal perforation of a Y-shaped sigmoid duplication. J Pediatric Surgery. 2001, Vol. 36, p. 1422-4.

Trotovsek B, Hribernik M, Gvardijancic D. Giant T-shaped duplication of the transverse colon. A case report. J Pediatr Surg. 2006; 41: E59-61.

Holcomb GW, Gheissari A, O’Neill JA et al. Surgical management of alimentary tract duplications. Ann Surg. 1989; 209: 167-74.

Iyer CP, Mahour GH. Duplications of the alimentary tract in infants and children. J Pediatr Surg. 1995; 30: 1267-70.

Bremer JL. Diverticula and duplications of the intestinal tract. Arch Pathol. 1944; 38: 132-40.

Lewis FT, Thyng FW. Regular occurrence of intestinal diverticula in embryos of pig, rabbit, and man. Am J Anat. 1908; 7: 505-19.

Blinder G, Hiller N, Adler SN. A double stomach in an adult. Am J Gastroenterol. 1999; 94: 1100-1102.

Bentley JF, Smith JR. Developmental posterior enteric remnants and spinal malformations: the split notochord syndrome. Arch Dis Child. 1960; 35: 76-86.

Edwards, H. Congenital diverticula of the intestine: With the report of a case exhibiting heterotopia. Brit. J. Surg. 1929; 17: 7-21.

Favara B.E, Franciosi R.A, Akers D.R. Enteric duplications: thirty seven cases. A vascular theory of pathogenesis. Am J. Dis Child. 1971; 122: 501-506.

Brown RI, Azizkhan RG. Gastrointestinal bleeding in infants and children. Semin Pediatr Surg. 1999; 8 (4): 202-9.

Patiño Mayer J, Bettolli M. Alimentary tract duplications in newborns and children: diagnostic aspects and the role of laparoscopic treatment. World J Gastroenterol. 2014 Oct 21; 20(39):14263-71.

Di Serafino M, Mercogliano C, Vallone GF. Ultrasound evaluation of the enteric duplication cyst: the gut signature. J Ultrasound. 2015 Nov 23;19(2):131-3.

Abdur-Rahman LO, Abdulkadir AY, Nasir AA, Ibrahim OOK, Adeniran JO, Adesiyun OAM. Gastrointestinal Duplications: Experience in Seven Children and a Review of the Literature. Saudi J Gastroenterol. 2010; 16(2): 105–9.

Inoue Y, Nakamura H. Adenocarcinoma arising in colonic duplication cysts with calcification: CT findings of two cases. Abdom Imaging. 1998; 23: 135-7.

Hsu CF, Huang FC, Ko SF et al. Duplication of transverse colon: report of one case. Acta Paediatr Taiwan. 2003; 44: 47-9.

Cook AK, Dorman G, Redman CW. A duplication of the descending colon presenting in pregnancy. Journal of Obstetrics and Gynaecology. 1999; 19 (4): 423.

Chang YT, Lee JY, Liao YM, Chiou SS. Laparoscopic resection of a giant retroperitoneal T-shaped duplication of descending colon. Journal of Pediatric Surgery. 2008; 43: 401-4.

Radich GA, Altinok D, Adsay NV, Soulen RL. Papillary adenocarcinoma in a small-bowel duplication in a pregnant woman. AJR Am J Roentgenol. 2006 Mar; 186(3): 895-7.

Ragab O, Landay M, Shriki J. Complete cloacal duplication imaged before and during pregnancy. J Radiol Case Rep. 2009; 3(11): 24-8.

Kiu V, Liang JT. Laparoscopic resection of Y-shaped tubular duplication of the sigmoid colon: report of a case. Dis Colon Rectum. 2010; 53 (6): 949-52.