Management of total colonic duplication: retrospective single institution Chinese study.

PURPOSE: To summarize the clinical features and surgical treatments of patients with total colonic duplication (TCD).

METHODS

Clinical data on 7 TCD patients who underwent surgical treatments at Beijing Children's Hospital from January 2010 to December 2024 was retrospectively collected and analyzed, including clinical presentations, surgical details, and prognosis.

RESULTS

Of the 7 patients, 4 (57%) were female. In addition to 1 patient whose prenatal ultrasound revealed abnormalities, abnormalities were found in all patients after birth, including 3 passing meconium through the fossa vestibuli vaginae, 2 with constipation/vomiting, 1 with cloaca, and 1 passing meconium through the urethra. Of the 7 patients, 2 were accurately diagnosed and treated in time (the patient with cloaca who underwent colostomy and the patient who was examined in our outpatient department after birth), and 5 (71%) were not. The average age at hospitalization was 14 (6-138) months. Before hospitalization, 4 patients (57%) experienced rectal mass prolapse during defecation. All patients underwent laparotomy, including 5 undergoing the "distal cross-section, mucosa stripping and closure" procedure, 1 resection of the distal duplicated colon with the proximal end closed and ileostomy, and 1 Soave procedure and ileostomy. All patients recovered well without fecal incontinence except for the patient with cloaca who defecated more than 3 times per day.

CONCLUSION

In addition to abnormalities after birth, rectal mass prolapse may be a specific presentation of TCD. The aim of surgery for TCD is to connect the duplicated and native colon and ligate the fistula.