Anterior colorectal duplication presenting as rectal prolapse

Abstract

Duplications of the gastrointestinal (GI) tract are rare. Only 5% of them are rectal and there are very few reports of rectal prolapse (RP) caused by a duplication. An 11 month-old female presented with a RP caused by a blind-ended anterior tubular colorectal duplication. The duplication was successfully opened and connected to the normal rectum without complications. Although infrequent, a rectal duplication should be considered in the differential diagnosis of RP.

Perineal mass protrusion with rectal mucosa: a rectal duplication that underwent exstrophy

“…The embryologic mechanism for rectal duplication remains unclear; however, the most widely accepted explanation is the split notochord theory [3]. Rectal duplications are most often located in the retrorectal space; anterior rectal duplications are therefore eminently rare [4].…”

“…Other clinical manifestations may include an external cyst derived from the dentate line [5], a mass protruding through the anus during defecation [3], or recurrent perineal abscess [6]. …”

Rectosigmoid tubular duplication presenting as perineal sepsis in a neonate

“…These cysts often remain asymptomatic until complications occur, such as an asymptomatic perineal mass, constipation, tenesmus, prolapse, low back pain, urinary symptoms, fistula formation, and the presence of a perineal inflammatory mass [6][7][8][9][10][11][12]. Occasionally, such cysts contain ectopic gastric mucosa, which may cause ulceration and bleeding into the cyst.…”

Colorectal tubular enteric duplication

“…6 However, among the pelvic masses associated with rectal prolapse, enteric communicating duplication in a female has been previously described. 6 Imaging should include cross-sectional imaging to exclude genitourinary anomalies. The most helpful diagnostic study is a contrast study simultaneously opacifying the native colon and the tubular duplication.…”

“…1 Owing to the risk of hemorrhage and malignant degeneration of the duplicated mucosal segment, a complete surgical excision of the mucosa is considered as the procedure of choice. 6 …”