Clinical features of colorectal duplication in children: A study of 25 cases.

PURPOSE: To describe the clinical features and surgical management of pediatric colorectal duplication.

METHODS

Twenty-five patients with colorectal duplication at Beijing Children's Hospital between January 2010 and December 2020 were reviewed. Colorectal duplications were divided into cystic, diverticular, tubular and mixed types according to shape.

RESULTS

Of the patients, 64% were female, and 44% had accompanying malformations. Abnormal prenatal ultrasound findings (24%), abnormalities immediately found after birth (28%), and postnatal subjective symptoms (48%) were the main clinical presentations. Cystic lesions were observed in 16 patients (64%), including 12 in the colon and 4 in the rectum. Diverticular lesions were observed in 4 patients (16%), and all originated from the sigmoid colon. Among the 4 patients (16%) with tubular lesions, 3 involved the total colon, and the other originated from the splenic flexure to the proximal sigmoid colon. The patient with mixed duplication presented an intact enteric cyst within tubular duplication of the total colon. The mean age at surgery was 20 (0.3-130) months. Except for 4 total colon duplications, complete surgical resection of duplication lesions was performed in all patients. The "distal cross-section, mucosa stripping, and closure" procedure was performed in 3 patients with total colon duplication. Eighteen patients (72%) were followed up for a median time of 54.5 (5-129) months and recovered uneventfully.

CONCLUSIONS

Owing to various clinical presentations, colorectal duplication requires careful preoperative differential diagnosis. Complete surgical resection is the preferred radical method for treating cystic, diverticular and short tubular colorectal duplications, except for total colon duplications.

LEVEL OF EVIDENCE: Level IV.