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Intestinal Duplication

By William J. Cochran, MD, Geisinger Clinic, Danville, PA

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Intestinal duplications are tubular structures attached to the intestines that share a common blood supply; their lining resembles that of the GI tract.

Duplications can be cystic or tubular depending on their length.

Intestinal duplications are rare, occurring in just 1 in 100,000 live births. Males appear to be more commonly affected (60 to 80% of cases). About one third of affected children have associated congenital anomalies.

The etiology of intestinal duplications is unknown. Theories include abnormalities in recanalization, a vascular insult, persistence of embryonic diverticula, and partial twinning.

The most common site of duplication is the jejunum and ileum followed by the colon, stomach, duodenum, and esophagus. Colonic duplication is often associated with anomalies of the urogenital system. Intestinal duplications usually manifest in the 1st or 2nd yr of life.

Duplications can be asymptomatic or cause obstructive symptoms, chronic pain, GI bleeding, or abdominal mass.

If they are detected, treatment of intestinal duplications is surgical with complete resection of the duplicated portion. For proximal lesions, an endoscopic approach can be considered when a highly skilled endoscopist is available ( 1, 2, 3).

References

1. Arantes V, Nery SR, Starling SV, et al : Duodenal duplication cyst causing acute recurrent pancreatitis, managed curatively by endoscopic marsupialization. Endoscopy 44(supplement 2):E117–E118, 2012. doi: 10.1055/s-0031-1291674.

2. Meier AH, Mellinger JD : Endoscopic management of a duodenal duplication cyst. J Pediatr Surg 47:e33–e35, 2012. doi: 10.1016/j.jpedsurg.2012.07.035.

3. Ballehaninna UK, Nguyen T, Burjonrappa SC : Laparoscopic resection of antenatally identified duodenal duplication cyst. JSLS 17:454–458, 2013. doi: 10.4293/108680813X13693422521151.

* This is the Professional Version. *