Case Report
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Dec 6, 2022; 10(34): 12768-12774
Published online Dec 6, 2022. doi: 10.12998/wjcc.v10.i34.12768
Colonic tubular duplication combined with congenital megacolon: A case report
Zhe-Ming Zhang, Shuai Kong, Xin-Xin Gao, Xiang-Hao Jia, Chun-Ning Zheng
Zhe-Ming Zhang, Xiang-Hao Jia, School of Clinical Medicine, Weifang Medical University, Weifang 261053, Shandong Province, China
Shuai Kong, Xin-Xin Gao, Chun-Ning Zheng, Department of Gastrointestinal Surgery, Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250000, Shandong Province, China
Author contributions: Zhang ZM drafted, reviewed, and revised the manuscript; Zheng CN was the primary physician during the patient’s hospital stay; Kong S, Gao XX, and Jia XH provided the images; all authors have read and approved the final manuscript.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest to report.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Chun-Ning Zheng, MD, PhD, Professor, Department of Gastrointestinal Surgery, Provincial Hospital Affiliated to Shandong First Medical University, No. 324 Jingwuweiqi Road, Huaiyin District, Jinan 250000, Shandong Province, China.yinzx123@163.com
Received: September 20, 2022
Peer-review started: September 20, 2022
First decision: October 13, 2022
Revised: October 21, 2022
Accepted: November 11, 2022
Article in press: November 11, 2022
Published online: December 6, 2022
Processing time: 73 Days and 0.6 Hours
Abstract
BACKGROUND

Colonic duplication refers to a spherical or tubular cavity which shows similar properties with the native colon and is attached to the mesenteric side of the alimentary tract. It is the rarest in alimentary tract duplications. Based upon anatomic feature, colonic duplications can be classified as spherical (cystic) or tubular, with the latter being less common (approximately 20%). Symptoms of colonic duplication are dependent on the duplication site and extent, and patient age, etc. Usually, patients with colonic duplication manifest typical intestinal obstruction, potentially accompanied by recurrent dark or bright red bloody stool, varying degrees of anemia-related symptoms, and body wasting.

CASE SUMMARY

A young male patient was admitted to our hospital due to recurrent abdominal pain. No definite diagnosis was achieved by computed tomography (CT) or electronic colonoscopy, and the bowel preparation efficacy was suboptimal. Hirschsprung disease was suspected, and thus laparoscopic exploration was performed. An approximately 60-cm-long inverted duplicated colon with severe edema and dilation was identified. It originated from the mesenteric side of the transverse colon and ended in the terminal part of the descending colon with a blind end. The parallel native colon had a thickened colonic wall, became stiff, and was poor in peristalsis. The patient then underwent subtotal colectomy and was discharged 7 d after the surgery. From 3 mo post-surgery to date, the patient had regular bowel movement once daily and a steady increase in body weight.

CONCLUSION

Tubular colonic duplication is a rare type of alimentary tract duplication that can be detected by ultrasonography, CT, or magnetic resonance imaging based on the actual clinical situation. Surgical resection of aberrant colon (including the duplicated colonic segment and other potentially involved colonic segments) is the only approach to cure this medical condition.

Keywords: Colonic duplication; Chronic constipation; Subtotal colectomy; Congenital megacolon; Case report

Core Tip: The incidence of tubular duplication malformations of the colon is very low. Patients usually present with intestinal obstruction. Accurate imaging is not yet fixed, and the diagnosis is usually clear only during surgery, which is the only effective treatment.