Galván-Montaño A, Guzmán-Martínez S, Lorenzana-Sandoval C, Recinos-Carrera E

Language: Spanish
References: 13
Page: 549-552
PDF size: 357.12 Kb.

ABSTRACT

Background: Duplications of the alimentary tract are a group of rare malformations occurring in about 1/5,000 live birth. These may be either spherical or tubular and may communicate with the intestinal tract. Duplications of the cecum are very uncommon.
Clinical case: A 14-year-old female was admitted to the emergency department with a 1-day history of abdominal pain, vomiting, constipation and abdominal distension. Abdominal examination revealed distension and tenderness around the umbilicus. Plain abdominal radiography showed dilated colon. The patient underwent surgical management with diagnosis of sigmoid volvulus. Laparotomy revealed spherical duplication from the cecum. Hemicolectomy was done and alimentary continuity was restored by end-to-end anastomosis. Pathological report was a spherical communicated duplication from the cecum (22 × 32 cm).
Conclusions: Duplication of the cecum is extremely rare and is seen in 0.4% of duplications of the alimentary tract. The majority of cases (85%) are diagnosed before age 2 years. It is rare at 14 years of age. Diagnosis is difficult and volvulus, intussusception or appendicitis should be considered in the differential diagnosis. Ultrasonography and tomography are the imaging studies of choice. Plain abdominal x-ray is not specific. Resection of the duplication with restoration of alimentary continuity is the treatment of choice.

REFERENCES

1. Kim EP, McClenathan JH. Unusual duplication of appendix and cecum: extension of the Cave-Wallbridge classification. J Pediatr Surg 2001;36:18-19.

2. Holcomb GW III, Gheissari A, O’Neill JA, Shorter NA, Bishop HC. Surgical management of alimentary tract duplications. Ann Surg 1988;209:169-174.

3. Bremer JL. Diverticula and duplications of the intestinal tract. Arch Pathol 1944;38:132-140.

4. Lewis FT, Thyng FW. Regular occurrence of intestinal diverticula in embryos of pig, rabbit and man. Am J Anat 1908;7:505-519.

5. Mellish RWP, Koop CE. Clinical manifestations of duplication of the bowel. Pediatrics 1961;27:397-407.

6. Haratz-Rubinstein N, Sherer DM. Prenatal sonographic findings of congenital duplication of the cecum. Obstet Gynecol 2003;101:1085-1087.

7. Wrenn EL Jr. Duplicaciones del tubo digestivo. En: Ashcraft KW, Holder TM, ed. Cirugía Pediátrica. México: McGraw-Hill; 1995. pp. 434-447.

8. Bentley JFR, Smith JR. Developmental posterior enteric remnants and spinal malformations. Arch Dis Child 1960;35:76-86.

9. Oudshoorn JH, Heij HA. Intestinal obstruction caused by duplication of the cecum. Eur J Pediatr 1996;155:338-340.

10. Shin KS, Lee NH, Kim SY. An unusual case of colonic duplication causing chronic constipation in a child. J Pediatr Surg 1999;34:1410-1412.

11. Oguzkurt P, Oguzkurt L, Kayaseluck F, Oz S. An unusual cause of acute abdomen: torsion of colonic duplication over a duplicated appendix. Pediatr Surg Int 2004;20:72-73.

12. Trotovsek B, Hribernik M, Gvardijancic D, Jelenec F. Giant Tshaped duplication of the transverse colon. A case report. J Ped Surg 2006;41:59-61.

13. Bishop HC, Koop CE. Surgical management of duplications of the alimentary tract. Am J Surg 1964;107:434-442.