Objectives

To review cases and literature in colonic duplication, a rare congenital condition.

Background

Gastrointestinal duplications are rare congenital malformations that may vary greatly in presentation, size, location, and symptoms. They often share common feeding vessels and communicate with normal bowel lumen. More frequently seen in the esophagus and ileum, whilst the colon only represents between 4% and 18 % of the cases.

Patients usually present with constipation and acute obstruction or infection is less commonly reported. The pathogenesis remains unknown and hypotheses have been proposed, incomplete recanalisation of the digestive tract lumen or intrauterine vascular insufficiency secondary to fetal stress and anoxia.

Imaging findings OR Procedure findings

Colonic and rectal duplication may be cystic or tubular, the later more common in the rectum. It is usually segmental and can be classified into the various types:

Segmental colonic duplication without other caudal duplication

- Non-communicating spherical duplication

- Non-communicating tubular duplication

- Communicating tubular duplication

Complete or segmental colonic duplication with genitourinary duplication.

- Duplication with two perineal openings

- Duplication with one or both segments ending as a fistula to the vagina, bladder or perineum

- Duplication with one or both segments imperforate and no fistula

If the cyst contains ectopic gastric or pancreatic tissue and communicates with the rectum, rectal bleeding may occur. Associated anomalies, especially of the vertebra, kidney, esophagus, or trachea, are present in nearly 40% of cases.

Conclusion

Colonic duplication is a rare condition that can be diagnosed in adulthood. Its complexity will determine the surgical approach, being radiology crucial in this planning.