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Virtual Pediatric Hospital: Correlapaedia - a Correlative Encyclopedia of Pediatric Imaging, Surgery, and Pathology: Case 36

Correlapaedia - a Correlative Encyclopedia of Pediatric Imaging, Surgery, and Pathology

Case 36

Michael P. D'Alessandro, M.D.,
Steven J. Fishman, M.D.,
Deborah E. Schofield, M.D.

Peer Review Status: Internally Peer Reviewed
Chief Complaint:
Four year old female who stools out of her vagina and rectum.

Clinical History:
This was a 4 year old female with a past history of duodenal atresia, omphalocele, atrial septal defect and ventricular septal defect. These were repaired early in life. At the time of the omphalocele repair, a duplicated colon was noted. The patient stools out of her vagina and her rectum, and now presents for definitive surgical correction.

Clinical Physical Exam:
Stool was noted in the vagina, as well as in the rectum.

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Clinical Labs:
Non-contributory

Clinical Differential Diagnosis:
Duplicated colon, partial versus complete.

Imaging Findings:
A barium enema was performed preoperatively to define the anatomy of the duplicated colon, and it showed complete colonic duplication. A Meckel scan was performed preoperatively (not provided) to rule out ectopic gastric mucosa in the colonic duplication, and it was negative.

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Imaging Differential Diagnosis:
Duplicated colon, complete.

Operative Findings:
An abdominal incision was made and the duplicated colon was exposed. The duplicated colon, which emptied into the vagina, was anastomosed to the normal colon at the level of the sigmoid colon.

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Pathological Findings:
None

Final Diagnosis:
Colonic Duplication (Total)

Follow-up and Prognosis:
The patient had an uncomplicated post-operative course. A postoperative enema showed a satisfactory post operative result. When injecting the rectum with barium there was simultaneously filling of both colonic lumens.

Similar Cases:
Case 28

References:
None

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