Cai Xuan, Bi Jing-Tao, Zheng Zhi-Xue, Liu Ya-Qi
Department of General Surgery, Beijing Jishuitan Hospital, Beijing 100035, China.
World J Clin Cases. 2022 Oct 26;10(30):11037-11043. doi: 10.12998/wjcc.v10.i30.11037.
Alimentary tract duplication (ATD) is a rare congenital anomaly. Thus, a case of ATD with a complete colonic duplication isolated in the abdominal cavity with a fistula and multiple malformations is very distinctive. These characteristics show the variability of this disease and explain why it tends to be challenging to diagnose and treat.
A 25-year-old woman with a history of a fistula opening in her right hip since birth presented with the irregular discharge of foul fluid from the fistula and intermittent abdominal pain. Contrast-enhanced computed tomography and magnetic resonance imaging findings revealed a duplicated tube isolated in her abdominal pelvic cavity along with a pelvic malformation and double ureter. Right foot radiographic examination showed pes cavus. During surgery, the tube appeared to be an almost complete colonic structure and was verified to be connected to the fistula. All of the involved tissue and fistula were removed, and the defect in the pelvic floor was closed by suturing after surgery. After 8 mo, the postoperative follow-up has been uneventful.
ATD may be a differential diagnosis in sinus tract cases. Laparoscopy combined with open surgery is a viable treatment option.
消化道重复畸形（ATD）是一种罕见的先天性异常。因此，一例孤立于腹腔内、伴有瘘管和多种畸形的完全性结肠重复畸形病例非常独特。这些特征显示了该疾病的变异性，并解释了为何其诊断和治疗往往具有挑战性。
一名25岁女性，自出生以来右髋部有瘘口，现出现瘘管有恶臭液体不规则流出及间歇性腹痛。增强计算机断层扫描和磁共振成像结果显示，在其腹腔盆腔内有一个孤立的重复管道，同时伴有盆腔畸形和双输尿管。右脚X线检查显示高弓足。手术中，该管道似乎是一个几乎完整的结肠结构，经证实与瘘管相连。术后切除了所有受累组织和瘘管，并通过缝合关闭了盆底缺损。8个月后，术后随访情况良好。
ATD可能是窦道病例的鉴别诊断之一。腹腔镜联合开放手术是一种可行的治疗选择。
