Gastrointestinal duplication is a rare congenital anomaly of the digestive tract, with colonic manifestations being particularly uncommon. Malignant transformation of colonic duplication cysts is rare, with adenocarcinoma being the most frequently reported type. Herein, we report a rare case of adenocarcinoma originating from a colonic duplication cyst.

A 49-year-old woman was found to have an elevated cancer antigen 19-9 level during a routine checkup. Imaging revealed a well-defined abdominal cavity cystic mass, which was initially suspected to be an ovarian teratoma. Laparoscopic surgery revealed a duplication cyst, and pathological examination confirmed adenocarcinoma arising from the cyst. The mass within the transverse mesocolon was successfully excised by a colorectal surgeon. Immunohistochemical analysis confirmed adenocarcinoma with invasion into the muscularis propria. Postoperative endoscopy and positron emission computed tomography scan showed no signs of malignancy, except for an elevated cancer antigen 19-9 level. A multidisciplinary team recommended no further chemotherapy, advising routine follow-up for monitoring.

Colonic duplications, though rare, remain a differential diagnosis of unexplained abdominal masses, with complete resection being their primary treatment approach.

• Gastrointestinal duplication
• Colonic duplication
• Surgical resection
• Adenocarcinoma
• Malignant transformation
• Case report

• Abdominal pain
• Anastomosis
• Case report
• Cystic lesion
• Intestinal duplication

The ileal duplication, which is a congenital anatomical abnormality of the digestive tract, can lead to the manifestation of the alimentary tract duplication in the small intestine. It is also the rare cause of gastrointestinal bleeding and usually seen in infants, but only rarely in adults. Herein, we describe a case of adult male was suffering from intermittent massive hematochezia for three years, accompanied by abdominal pain, syncope, and palpitations. However, no positive findings were found by gastroscopy and colonoscopy in other hospitals. He visited our hospital owing to the recurrent hematochezia, but re-examination by gastroscopy and colonoscopy indicated no significant abnormality, and hence small intestinal vascular malformation bleeding was considered. Therefore, double-balloon enteroscopy (DBE) examination was conducted and the results revealed a double-lumen opening in the ileum, which was 100 cm from the ileocecal valve. The blind end was observed 6 cm away from one opening along the depth direction, and an ulcer was observed on the intestinal wall of the blind segment, which was considered as an ileal duplication. The patient thereafter underwent surgery subsequently. Postoperative pathology confirmed ileal duplication and that gastrointestinal bleeding was primarily caused by ulcer hemorrhage. The patient had no discomfort after the follow-up. In this report, we have reviewed and summarized the literature to provide references for both diagnosis and treatment of ileal duplication.

• Natural Science Foundation of GuiZhou Province, China

Small intestine duplication cysts (SIDCs) are rare congenital anatomical abnormalities of the digestive tract and a rare cause of hematochezia.

We describe an adult female presented with recurrent hematochezia. The routine gastric endoscope and colonic endoscope showed no positive findings. Abdominal CT scan indicated intussusception due to the "doughnut" sign, but the patient had no typical symptoms. Two subsequent capsule endoscopes revealed a protruding lesion with bleeding in the distal ileum. Surgical resection was performed and revealed a case of SIDC measuring 6 * 2 cm located inside the ileum cavity. The patient remained symptom-free throughout a 7-year follow-up period.

SIDCs located inside the enteric cavity can easily be misdiagnosed as intussusception by routine radiologic examinations.

• Case report
• Hematochezia
• Small intestine duplication cyst

• Colonic surgery
• Congenital anomalies
• Intestinal duplication

Intestinal duplication, a congenital malformation, is considered a rare condition, particularly in adults. Although it affects young children, a minority of patients remains asymptomatic until adulthood. Here, we describe a case of an intestinal duplication cyst that caused intussusception by a unique mechanism.

A 19-year-old man was admitted to our hospital for intermittent abdominal pain. Computed tomography revealed colonic intussusception induced by a nodular mass in the ileocecal region. Urgent ileocecal resection was performed because of the risk of colonic ischemia. The resected material comprised a stool-filled noncommunicating cyst that protruded into the enteric lumen at the ileocecal valve. Histological analyses revealed that the inner wall of the cyst was lined with colonic mucosa and that the muscle layer of the cyst was shared with that of the original enteric wall; furthermore, the cyst had a vestige of an opening site in the wall. We concluded that the cyst was an intestinal duplication that poured stool into its lumen through the tiny orifice, thereby triggering intussusception.

The present case suggests that stool-pouring can cause intussusception into the space of an intestinal duplication lesion.

• Duplication cyst
• Ileocecal valve
• Intestinal duplication
• Intussusception

• Colonic duplication
• abdominal distension
• adenocarcinoma risk
• adult
• congenital anomaly
• intraoperative diagnosis

• Cecum/abnormalities
• Child
• Child, Preschool
• Congenital Abnormalities/diagnosis
• Congenital Abnormalities/surgery
• Female
• Humans
• Infant
• Infant, Newborn
• Male
• Retrospective Studies

Tubular duplication of the colon is very rare especially in adulthood, because it is frequently symptomatic earlier in newborn life, so only few cases are reported in literature. Several theories are proposed to explain the onset and the evolution of gut malformations as the aberrant lumen recanalization or the diverticular theory, the alteration of the lateral closure of the embryonal disk or finally the dorsal protrusion of the yolk-sac for herniation or adhesion to the ectoderm for an abnormality of the longitudinal line, but none clarifies the exact genesis of duplication. We present a case of “Y-shaped” tubular duplication of the transverse colon in a 21-year-old adult, with a history of chronic pain and constipation, referred to our department for abdominal pain with retrosternal irradiation, treated with the resection of the aberrant bowel.

• Colonic diseases
• Colorectal duplication
• Neogenesis
• Colonic duplication
• Transverse duplication

• Abdominal Pain/etiology
• Colectomy
• Colon, Transverse/abnormalities
• Colon, Transverse/surgery
• Constipation/etiology
• Digestive System Abnormalities/complications
• Digestive System Abnormalities/diagnosis
• Digestive System Abnormalities/surgery
• Humans
• Male
• Tomography, X-Ray Computed
• Treatment Outcome
• Young Adult

Enteric duplications are rare, but can occur anywhere along the digestive tract. Most of the patients become symptomatic in early childhood and only a few cases of adult patients have been reported in literature. Here we report a unique case of an adenocarcinoma arising in a coincidentally found cystic duplication of the small bowel.

• Adenocarcinoma
• Cecum
• Congenital abnormalities

• Adenocarcinoma/diagnostic imaging
• Adenocarcinoma/pathology
• Adenocarcinoma/surgery
• Adult
• Biopsy
• Cecal Neoplasms/diagnostic imaging
• Cecal Neoplasms/pathology
• Cecal Neoplasms/surgery
• Cecum/abnormalities
• Cecum/diagnostic imaging
• Cecum/surgery
• Colectomy
• Humans
• Male
• Tomography, X-Ray Computed
• Treatment Outcome

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.

• Adult
• Colonic duplication
• Congenital abnormalities
• Laparoscopy

• Adolescent
• Colon/abnormalities
• Colon/surgery
• Colonic Diseases/diagnostic imaging
• Crohn Disease/complications
• Crohn Disease/pathology
• Crohn Disease/surgery
• Diagnosis, Differential
• Female
• Fistula/diagnostic imaging
• Humans
• Intestinal Fistula/diagnostic imaging
• Radiography
• Uterine Cervical Diseases/diagnostic imaging