J Korean Surg Soc.  2012 Mar;82(3):190-194. 10.4174/jkss.2012.82.3.190.

Large tubular colonic duplication in an adult treated with a small midline incision

• Yong YG
• Jung KU
• Cho YB
• Yun SH
• Kim HC
• Lee WY
• Chun HK

• KMID: 2212222
• DOI: http://doi.org/10.4174/jkss.2012.82.3.190

Abstract

Tubular colonic duplication presenting in adults is rare and difficult to diagnose preoperatively. Only a few cases have been reported in the literature. We report a case of a 29-year-old lady presenting with a long history of chronic constipation, abdominal mass and repeated episodes of abdominal pain. The abdominal-pelvic computed tomography scan showed segmental bowel wall thickening thought to be small bowel, and dilatation with stasis of intraluminal content. The provisional diagnosis was small bowel duplication. She was scheduled for single port laparoscopic resection. However, a T-shaped tubular colonic duplication at sigmoid colon was found intraoperatively. Resection of the large T-shaped tubular colonic duplication containing multiple impacted large fecaloma and primary anastomosis was performed. There was no perioperative complication. We report, herein, the case of a T-shaped tubular colonic duplication at sigmoid colon in an adult who was successfully treated through mini-laparotomy assisted by single port laparoscopic surgery.

Keyword

Colonic duplication; Congenital abnormalities; Adult; Laparoscopy

MeSH Terms

Abdominal Pain
Adult
Colon
Colon, Sigmoid
Congenital Abnormalities
Constipation
Dilatation
Humans
Laparoscopy

Figure

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  Fig. 1 Axial view abdominal computed tomography scan showing thickened bowel wall (white arrow) and segmental dilatation with stasis of intraluminal content.

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  Fig. 2 Coronal view abdominal computed tomography scan showing longitudinal section of colonic duplication (white arrow).

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  Fig. 3 Fecaloma removed through incision on colonic duplication.

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  Fig. 4 Sigmoid and colonic duplication extracted through wound retractor. Note that duplication arises from mesenteric border of native colon and closely wrapped around by mesocolon.

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  Fig. 5 Final attachment of blind end of colonic duplication to peritoneum overlying aortic bifurcation.

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  Fig. 6 Resected specimen showing large T-shaped tubular colonic duplication measuring 23 cm in length. Note that feeding vessels were ligated flush to wall of colonic duplication to avoid injury of vessels to native colon.

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