Hindgut duplication

Abstract

A girl with a rare congenital malformation consisting of duplication of the urinary and genital tracts as well as of the entire colon, terminating in double rectogenital fistulas, is presented. Because of a small-capacity urinary bladder on one side and an atonic neurogenic bladder on the other side, urinary diversion was necessary. A preliminary diverting colostomy of the duplicated transverse colon was followed by anoplasty of one anus. Later on, the duplicated proximal colostomy was anastomosed to the one distal colon leading to the rectum with anoplasty. The treatment of this complex anomaly is described.

A Case Report of a Colorectal and Caudal Duplication Syndrome Associated with Caudal Regression Syndrome

“…The reported cases involve older children (aged between 2and 10 years old) presenting with complications resulting from a duplicated gastrointestinal tract (fecal incontinence [2], constipation, and abdominal distention [7]) or complications resulting from a duplicated urinary system (urinary frequency with severe vesico-ureteric reflux (VUR) and renal hypoplasia [7] or stress incontinence with recurrent episodes of UTIs [8]). Myelomeningocele was present in two cases [2,9], but none of the patients had any neurological deficits in the lower limbs.…”

“…The urologic complications in the reviewed cases [8,9] are more likely related to the late age of bladder duplication treatment and not by the spinal anomalies, proven by improvement after surgical reconstruction. In our case with type I sacral agenesis without spinal cord anomalies, the early treatment of both lipomyelomeningocele and bladder duplication led to excellent results regarding continence without urinary infection during follow-up.…”

“…We reviewed four similar reports of CDS [2,[7][8][9] with vertebral and lower limb malformations as components of caudal regression syndrome, but we believe that this association might be more frequent than is reported in the published literature. The reported cases involve older children (aged between 2and 10 years old) presenting with complications resulting from a duplicated gastrointestinal tract (fecal incontinence [2], constipation, and abdominal distention [7]) or complications resulting from a duplicated urinary system (urinary frequency with severe vesico-ureteric reflux (VUR) and renal hypoplasia [7] or stress incontinence with recurrent episodes of UTIs [8]).…”