Alimentary tract duplications in pediatric pathology

Abstract

Introduction. Alimentary tract duplications are congenital malformations which can occur anywhere from the mouth to anus. Their anatomical presentation varies widely and so their clinical picture, often making their management a challenge for the surgeon. Material and methods. We reviewed the medical records of 24 consecutive patients diagnosed and treated for ATD from 2006 to 2015 by our team. Results. The clinical presentation ranged broadly from recurrent abdominal pain or feeding difficulties to GI bleeding or bowel obstruction. Most of the ATDs were ileocecal (33%), followed by jejuno-ileal and colon, esophageal and duplication of the oral structures, rectal and anorectal. We feature an esophageal duplication cyst associating esophageal atresia. We also note a case of complex caudal duplication syndrome involving the ileum, appendix, cecum, colon and rectum assessed into a multidisciplinary team with very good outcomes. In half of the cases (50%) removal of the duplication required corresponding enterectomy. Conclusions. Alimentary tract duplications are rare malformations with a broad spectrum of anatomical particularities. Their clinical presentation and imaging studies can be misleading and in many situations intraoperative findings complete the picture of the case. Multidisplinary approach is mandatory in complex cases in order to bring up the best results.