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Gutierrez-Alvarez M, Leal J, Fuentes K, Sotelo F, Fuentes I, Camacho D. Anal Canal Duplication in a 25-Year-Old Female Patient. Cureus 2023; 15:e36516. [PMID: 37090320 PMCID: PMC10120606 DOI: 10.7759/cureus.36516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/22/2023] [Indexed: 04/25/2023] Open
Abstract
Anal canal duplication (ACD) is a congenital malformation that typically presents and is diagnosed early in life. It can be associated with other syndromes or congenital malformations. ACD is one of the rarest duplications of the gastrointestinal tract, with no more than 90 to 100 cases reported in the literature. It can be confused with more frequent pathologies such as perianal fistula, especially when it occurs in adulthood. We present the case of a 25-year-old female patient who presents with a second orifice above the native anal orifice. An arthroscopic examination was performed, an incidental diagnosis of ACD was made, and a complete excision of the duplicated anal canal was performed. The aim of the study is to expand the information on this rare pathology in order to take it into account as a differential diagnosis in patients with abscesses, recurrent fistulous tracts, or any other anorectal pathology.
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Affiliation(s)
| | - Jorge Leal
- General Surgery, Medica Sur, Mexico City, MEX
| | | | | | - Irving Fuentes
- Surgery, Universidad Popular Autonoma del Estado de Puebla, Puebla, MEX
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Dominguez-Muñoz A, Fernandez-Portilla E, Davila-Perez R, Lizarraga-Rodriguez I, Leyva-Castellanos MDL, Nieto-Zermeño J. Colorectal duplication with rectovestibular fistula treated through an anterior transanorectal approach. JOURNAL OF PEDIATRIC SURGERY CASE REPORTS 2022. [DOI: 10.1016/j.epsc.2022.102374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
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Lee SW, Kimble RM, Lumsden E, Wong M, Kendrick DJ. Currarino triad with a duplicate anal canal presenting with an infected sacral mass. JOURNAL OF PEDIATRIC SURGERY CASE REPORTS 2022. [DOI: 10.1016/j.epsc.2022.102185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Gupta R, Saini G, Gupta A. Sacrococcygeal teratoma Type IV presenting as anal canal duplication: Lessons learned. FORMOSAN JOURNAL OF SURGERY 2022. [DOI: 10.4103/fjs.fjs_229_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Rahul S, Keshri R, Prasad R, Chaubey D, Hasan Z, Kumar V, Thakur V, Yadav R, Kumar R, Bakhtiyar A. Duplications of the alimentary tract in infants and children. FORMOSAN JOURNAL OF SURGERY 2021. [DOI: 10.4103/fjs.fjs_137_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Akova F, Altinay S, Aydin E. The Controversy of Surgical Intervention for Anal Canal Duplication in Children. Pak J Med Sci 2020; 36:1330-1333. [PMID: 32968403 PMCID: PMC7501008 DOI: 10.12669/pjms.36.6.1832] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Objective: Since the first definition of anal canal little has been discovered about the etiology of this rare condition. We present four asymptomatic cases of anal canal duplication with diverse clinical and surgical findings. Methods: A retrospective chart review was performed on four infants presenting with asymptomatic anal canal duplication, born between 2014 and 2016. Clinical characteristics and pathologic findings of patients either by radiological imaging or pathology were evaluated. The primary outcome measure was the complications. Results: All patients were followed-up with physical examination and ultrasound for a mean of 3.5±1.0 years, lastly seen at the beginning of 2018. The female to male ratio was 3:1. Duplicate anal canal length varied between 12-20mm, and two of the four patients had a presacral cystic mass confirmed as a tail gut cyst following surgery. At follow-up, none of the patients had developed symptoms related to anal canal duplication, regardless of whether they had surgical intervention. Conclusion: Though surgical management is the preferred treatment for anal canal duplication, it seems that patients who do not undergo surgery might remain free of symptoms, suggesting that surgical intervention may be unnecessary.
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Affiliation(s)
- Fatih Akova
- Dr. Fatih Akova, MD. Assistant Professor, Pediatric Surgery Department, Biruni University, Istanbul, Turkey. Pediatric Surgery Department, University of Health Science, Faculty of Medicine, Bagcilar Training & Research Hospital, Istanbul, Turkey
| | - Serdar Altinay
- Dr. Serdar Altinay, MD. Associate Professor, Pathology Department, University of Health Science Bakırköy, Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - Emrah Aydin
- Dr. Emrah Aydin, MD. Assistant Professor, Pediatric Surgery Department, Koc University School of Medicine, Istanbul, Turkey
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Anastasiadou S, Tekkis P, Kontovounisios C. An unusual rectal duplication cyst. Surg Case Rep 2019; 5:75. [PMID: 31073805 PMCID: PMC6509302 DOI: 10.1186/s40792-019-0631-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2019] [Accepted: 04/22/2019] [Indexed: 11/12/2022] Open
Abstract
Background Rectal duplication cysts are rare gastrointestinal congenital duplicate cysts with various clinical presentations that require different management. Case presentation We present a case of a lady with a double rectal duplicate cyst which was found incidentally on a follow-up CT abdomen and pelvis scan. The patient initially had a mucocele excision, and following that, she had a non-contrast CT abdomen and pelvis to investigate post-operative pain. The CT scan revealed a single rectal duplicate cyst. She had a posterior approach excision to have it removed, and only intra-operatively, she was found to have a double rectal duplicate cyst. She had them both removed via a midline incision running from the perineal pigmentation and extending until the coccyx. She had another follow-up CT which showed complete excision of the cysts. Conclusions After a thorough review of the literature regarding rectal cysts, there was no mention of a double rectal duplicate cyst. The purpose of this paper is to point out the various potential presentations of a rectal cyst as well as the idea that a double cyst is managed effectively in a similar way as the single one.
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Affiliation(s)
- Sofia Anastasiadou
- Department of Colorectal Surgery, Charing Cross Hospital, Chelsea and Westminster Hospital, Imperial Healthcare Trust, London, UK. .,Department of Surgery and Cancer, Imperial College, London, UK.
| | - Paris Tekkis
- Department of Colorectal Surgery, Charing Cross Hospital, Chelsea and Westminster Hospital, Imperial Healthcare Trust, London, UK.,Department of Colorectal Surgery, Royal Marsden Hospital, London, UK.,Department of Surgery and Cancer, Imperial College, London, UK
| | - Christos Kontovounisios
- Department of Colorectal Surgery, Charing Cross Hospital, Chelsea and Westminster Hospital, Imperial Healthcare Trust, London, UK.,Department of Colorectal Surgery, Royal Marsden Hospital, London, UK.,Department of Surgery and Cancer, Imperial College, London, UK
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Park J. Anal canal duplication associated with presacral teratoma in a 5-year old girl. JOURNAL OF PEDIATRIC SURGERY CASE REPORTS 2017. [DOI: 10.1016/j.epsc.2017.02.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Arakawa T, Hwang SE, Kim JH, Wilting J, Rodríguez-Vázquez JF, Murakami G, Hwang HP, Cho BH. Fetal growth of the anal sinus and sphincters, especially in relation to anal anomalies. Int J Colorectal Dis 2016; 31:493-502. [PMID: 26615552 DOI: 10.1007/s00384-015-2455-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/19/2015] [Indexed: 02/04/2023]
Abstract
PURPOSE AND METHODS The anal sinuses, small furrows above the pectinate line, sometimes form perianal abscesses in adults. We examined the pattern of fetal growth of the anal sinus and sphincters using 22 mid-term (8-18 weeks) and 6 late-stage (30-38 weeks) fetuses. RESULTS In mid-term fetuses, the external and internal sphincters gradually increased in thickness, depending on specimen size (from 0.2 to 1.5 mm), whereas the anteroposterior diameter of the anal canal at the epithelial junction was relatively stable (0.5-1.0 mm) irrespective of specimen size. Anal canal diameter increased less than twofold between mid-term and late-stage fetuses, from 0.5-1.0 to almost 2 mm, whereas sphincter thickness increased over tenfold, from 0.2-1.5 to almost 3.5 mm. The anal sinus often showed balloon-like enlargement when the sphincter muscle bundles were tightly packed in mid-term, but not in late-stage fetuses. CONCLUSIONS Large concentric mechanical stress from the sphincters in late-stage fetuses apparently prevented the anal sinus from expanding in a balloon-like manner. Conversely, to avoid anal stenosis, the growing sinuses maintained a luminal space of the anal canal in response to stress from rapidly growing sphincters. The inferiorly extending sinus usually provided temporal double canals separated by a thick column. In the presence of double lumens, anal canal duplication is likely to develop without any abnormalities of the anal epithelium and sphincters.
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Affiliation(s)
| | - Si Eun Hwang
- Department of Surgery, Daejeon Sun Hospital, Daejeon, Republic of Korea
| | - Ji Hyun Kim
- Department of Anatomy, Chonbuk National University Medical School, Geonji-ro 20, Deokjin-gu, Jeonju, 561-712, Republic of Korea.
| | - Joerg Wilting
- Department of Anatomy, School of Medicine, Georg-August-Universität Gőtingen, Gőttingen, Germany
| | - José Francisco Rodríguez-Vázquez
- Department of Anatomy and Human Embryology, Institute of Embryology, Faculty of Medicine, Universidad Complutense, Madrid, Spain
| | - Gen Murakami
- Division of Internal Medicine, Iwamizawa Asuka Hospital, Iwamizawa, Japan
| | - Hong Pil Hwang
- Department of Surgery & Biomedical Research Institute, Chonbuk National University Hospital, Jeonju, Republic of Korea
| | - Baik Hwan Cho
- Department of Surgery & Biomedical Research Institute, Chonbuk National University Hospital, Jeonju, Republic of Korea
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Cheng LS, Courtier J, MacKenzie TC. Anal duplication in a one-year-old girl. JOURNAL OF PEDIATRIC SURGERY CASE REPORTS 2013; 1:373-374. [PMID: 25774340 DOI: 10.1016/j.epsc.2013.10.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
We report a case of a patient with anal duplication discovered incidentally at 1 year of age. Pre-operative evaluation excluded any complications or associated anomalies. She underwent surgical excision with an excellent outcome.
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Affiliation(s)
- Lily S Cheng
- University of California San Francisco, 500 Parnassus Ave., San Francisco, CA 94143, USA
| | - Jesse Courtier
- University of California San Francisco, 500 Parnassus Ave., San Francisco, CA 94143, USA
| | - Tippi C MacKenzie
- University of California San Francisco, 500 Parnassus Ave., San Francisco, CA 94143, USA
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Van Biervliet S, Maris E, Vande Velde S, Vande Putte D, Meerschaut V, Herregods N, De Bruyne R, Van Winckel M, Van Renterghem K. Anal canal duplication in an 11-year-old-child. Case Rep Gastrointest Med 2013; 2013:503691. [PMID: 24151565 PMCID: PMC3787627 DOI: 10.1155/2013/503691] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2013] [Accepted: 08/13/2013] [Indexed: 11/18/2022] Open
Abstract
Anal canal duplication (ACD) is the least frequent digestive duplication. Symptoms are often absent but tend to increase with age. Recognition is, however, important as almost half of the patients with ACD have concomitant malformations. We present the clinical history of an eleven-year-old girl with ACD followed by a review of symptoms, diagnosis, treatment, and prognosis based on all the reported cases in English literature.
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Affiliation(s)
- S. Van Biervliet
- Departement of Pediatric Gastro-Enterology, Ghent University Hospital, De Pintelaan 185, 9000 Ghent, Belgium
| | - E. Maris
- Departement of Pediatric Gastro-Enterology, Ghent University Hospital, De Pintelaan 185, 9000 Ghent, Belgium
| | - S. Vande Velde
- Departement of Pediatric Gastro-Enterology, Ghent University Hospital, De Pintelaan 185, 9000 Ghent, Belgium
| | - D. Vande Putte
- Departement of Pediatric Surgery, Ghent University Hospital, De Pintelaan 185, 9000 Ghent, Belgium
| | - V. Meerschaut
- Departement of Pediatric Radiology, Ghent University Hospital, De Pintelaan 185, 9000 Ghent, Belgium
| | - N. Herregods
- Departement of Pediatric Radiology, Ghent University Hospital, De Pintelaan 185, 9000 Ghent, Belgium
| | - R. De Bruyne
- Departement of Pediatric Gastro-Enterology, Ghent University Hospital, De Pintelaan 185, 9000 Ghent, Belgium
| | - M. Van Winckel
- Departement of Pediatric Gastro-Enterology, Ghent University Hospital, De Pintelaan 185, 9000 Ghent, Belgium
| | - K. Van Renterghem
- Departement of Pediatric Surgery, Ghent University Hospital, De Pintelaan 185, 9000 Ghent, Belgium
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