Ann Surg Treat Res.  2016 Oct;91(4):207-211. 10.4174/astr.2016.91.4.207.

Complete tubular duplication of colon in an adult: a rare cause of colovaginal fistula

• Jung HI
• Lee HU
• Ahn TS
• Lee JE
• Lee HY
• Mun ST
• Baek MJ
• Bae SH

• KMID: 2354329
• DOI: http://doi.org/10.4174/astr.2016.91.4.207

Abstract

Alimentary tract duplications are uncommon congenital anomalies that usually present during the first decade of life. Complete duplication of the colon in adults is very rare and difficult to diagnose preoperatively. We report a case of a 40-year-old female with complete tubular duplication which was initially misdiagnosed as a salpingeal abscess due to colovaginal fistula.

Keyword

Complete tubular duplication; Colon

MeSH Terms

Abscess
Adult*
Colon*
Female
Fistula*
Humans

Figure

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  Fig. 1 CT findings. Inflammatory change around the left side of the colon and left ovary (white [A] and black [B] arrow) with loculated fluid collection in the A B pelvic cavity.

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  Fig. 2 Laparoscopy showing 2 appendices (white [A] and black [B] arrow) with inflammatory adhesion between the sigmoid colon and the left salpinx.

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  Fig. 3 (A) Tubular duplication of the total colon consisting of the cecum, ascending, transverse, descending colon and the narrowed portion. (B) The distal end of the fistula was connected to the vaginal posterior wall. (C) Fistulogram with indigocarmine. (D) Both ends of the duplicated bowel were resected by using GIA 60 (Tyco Healthcare, Norwalk, CT, USA).

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  Fig. 4 (A) Diagram illustrating 2 appendices and duplicated segments. (B) Remnant duplication like a fistulous tract was observed (the dash line) between the terminal part of the duplicated descending colon and the posterior vaginal wall.

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  Fig. 5 Chronic inflammation and a hamartomatous polyp in the descending colon (H&E, ×400).

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