Colonic duplication in an adult mimicking a tumor of pancreas

Adult Cystic Intestinal Duplication of the Ileum Laparoscopically Resected after Preoperative Diagnosis with Cine Magnetic Resonance Imaging and Abdominal Ultrasound: A Case Report

INTRODUCTION

Small bowel duplication in adults is an uncommon congenital anomaly that often presents with nonspecific symptoms, such as abdominal pain, vomiting, or constipation, which complicates diagnosis. Imaging techniques such as computed tomography (CT) and ultrasonography are commonly used, and cine magnetic resonance imaging (MRI) has emerged as a promising modality for diagnosing duplication cysts by capturing peristaltic movements. Surgical resection is the definitive treatment for preventing complications such as obstruction, infection, or malignant transformation.

CASE PRESENTATION

A woman in her thirties visited the emergency department with persistent lower abdominal pain. Physical examination and laboratory tests, including those for tumor markers, were unremarkable. CT revealed a cystic mass near the uterus, and pelvic MRI revealed a cystic lesion that had migrated during follow-up imaging. Cine MRI showed peristaltic movements within the lesion, and abdominal ultrasonography confirmed a cystic structure with wall movements resembling intestinal peristalsis. Based on these findings, the diagnosis of a noncommunicating small bowel duplication cyst was made.The patient underwent a laparoscopic single-port partial resection of the ileum. A cystic lesion located 75 cm proximal to the terminal ileum was excised along with a segment of the small intestine. Histopathological examination revealed a duplicated cyst lined with the small intestinal mucosa, confirming the diagnosis. The postoperative course was uneventful, and the patient was discharged 1 week postoperatively.

CONCLUSION

This case highlights the utility of cine MRI and ultrasonography in the preoperative diagnosis of small bowel duplication cysts. In particular, cine MRI provides dynamic visualization of peristaltic movements within the cyst, enabling a confident diagnosis. The migration of the cyst observed on serial MRI examinations further corroborated the origin of this duplication. These findings emphasize the importance of advanced imaging modalities in the diagnosis of rare intestinal anomalies. Preoperative diagnosis of small bowel duplication cysts can be significantly enhanced by using cine MRI and ultrasonography to detect peristaltic movements. These modalities offer critical insights that aid timely surgical intervention and improve outcomes.

Giant duplication of the transverse colon in an adult: A case report and literature review

Intestinal duplication is a rare congenital malformation that can occur in any segment of the digestive tract. It is most commonly found in the ileum of infants and is rarely reported in adults, especially in the colon. Diagnosing intestinal duplication can be extremely challenging due to its diverse clinical manifestations and complex anatomical structure. Surgical intervention is currently considered the mainstay of treatment. In this report, we presented a case of giant duplication of the transverse colon in an adult.

Tubular colonic duplication in an adult: case report and brief literature review

Gastrointestinal tract duplication is a rare congenital anomaly that can occur anywhere along the alimentary tract. Most of the reported patients present with acute abdomen during childhood. We describe a case of tubular colonic duplication in an adult. The patient was a 25-year-old woman who presented with abdominal pain, bloating, nausea, and emesis for 3 days. The physical examination was remarkable for abdominal distension, tenderness, and rigidity. Abdominal computed tomography scan revealed abnormal intestinal dilatation. Exploratory laparotomy was performed, and tubular colonic duplication was identified intraoperatively. The diagnosis was verified by postoperative pathology results. The patient was discharged on postoperative day 14 and followed for 2 years without specific events or complications. Furthermore, we reviewed the published literature on colorectal duplication in adults for the past two decades.

Congenital intestinal duplication in an adult

Congenital intestinal duplication is an anomaly most commonly diagnosed in children under the age of 2. Rarely, it is seen in adults who remain asymptomatic or present with vague abdominal symptoms. Here, we describe the case of a 33-year-old female who was diagnosed intraoperatively with congenital intestinal duplication after suffering from a year of vague abdominal complaints.

Total colorectal and terminal ileal duplication presenting as intussusception and intestinal obstruction

Colonic intussusception and gastrointestinal duplication are diseases that arise in young children. The clinical presentation of adult cases of intussusception and enteric duplication is non-specific and thus poses a diagnostic challenge. A computed tomography (CT) scan is recommended in adult cases as the most sensitive diagnostic tool and the pathognomonic finding of outer intussuscepiens and central intussusceptum is diagnostic. A septum of a duplicated colon in a non-intussuscepted segment has been rarely reported in the literature. With advancements in radiological imaging technology and the increased availability of CT scanners, the capacity for a correct pre-operative diagnosis has been significantly enhanced. Our current case report illustrates the importance of considering an uncommon etiology for enteric intussusception and duplication as a differential diagnosis of acute abdomen in an adult patient. Our analyses of this patient also highlight the successful use of CT scanning to make this diagnosis.

Large tubular colonic duplication in an adult treated with a small midline incision

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.