Rectal duplications

Abstract

Recent experience with two cases of rectal duplication, which had been misdiagnosed as hemorrhoids, or fistula-in-ano with resultant delay in diagnosis, prompted us to review our prior experience with 11 of these unusual cases. Age at presentation ranged from newborn to 18 years (mean, 17 months). The most common presenting sign was a perianal or anal fistula, observed in five children. Two children presenting with fistulae had concomitant infection in the duplication. Other presenting signs included obstruction or prolapse caused by the rectal mass in three patients, rectal bleeding in three, and urinary retention in one. Some children presented with more than one finding. No associated spinal or vertebral anomalies were observed. Total excision was performed using a transanal approach in eight patients, postanal (transcoccygeal) in two, and posterior sagittal in one. Postoperative continence was normal in all patients. These cases illustrate that rectal duplications can be confused with other types of anorectal pathology including hemorrhoids, fistula-in-ano, and perirectal abscess. Total excision performed using a posterior sagittal, transanal, or transcoccygeal approach is curative.

Rectal duplication, rare cause of constipation — case report

“…With 2-4% of all GI duplications, rectal duplications are extremely rare [6,7] and they are located mostly in retrorectal space [8]. It is generally assumed that duplications are the result of an error in notochord development (split notochord theory), with coexisting vertebral and genitourinary malformations or intestinal atresias.…”

Pelvic neoplasms in children

“…A duplication cyst of the rectum usually presents as a pelvic mass [7]. Specialists in pediatric surgery and pediatric radiology are needed to diagnose and treat these lesions.…”

Retrorectal Dermoid Cyst

“…The differential diagnosis of retrorectal cyst includes other developmental cysts such as epidermoid cysts, enteric cysts, tailgut cysts, and duplication cysts. Other cystic lesions such as cystic sacrococygeal teratoma, anterior sacral meningocele, anal duct cyst, necrotic rectal leiomyosarcoma, extraperitoneal adenomucinosis, cystic lymphangioma, pyogenic abcess, neurogenic cyst, necrotic sacral chordoma are also included in the differential diagnosis [2,3,6,7]. Because of the risks of recurrence, malignant degeneration and chronic infection, the treatment of choice for retrorectal dermoid cysts is complete surgical excision [1][2][3].…”

“…Dimples or fistulas involving the perianal skin or the anal canal may be present. Symptoms are often related to local compression on the rectum, which causes constipation, rectal fullness, painful compression and lower abdominal pain, Erkan/Agdeniz/Fırat Polat/Yıldırım and to local compression of the lower urinary tract causing dysuria and increased urinary frequency [2,6,7]. Developmental cysts are commonly revealed by complications such as local infection, perianal fistula or rectal bleeding [5,7].…”