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Year : 2023  |  Volume : 28  |  Issue : 6  |  Page : 546-547
 

A case of Y tubular duplication of the sigmoid colon in a pediatric patient


Departments of Paediatric Surgery, PSG Institute of Medical Sciences and Research, Coimbatore, Tamil Nadu, India

Date of Submission20-Jul-2023
Date of Decision25-Aug-2023
Date of Acceptance27-Aug-2023
Date of Web Publication02-Nov-2023

Correspondence Address:
Pavai Arunachalam
Department of Paediatric Surgery, PSG Institute of Medical Sciences and Research, Peelamedu, Coimbatore - 641 004, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jiaps.jiaps_157_23

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How to cite this article:
Arunachalam P, Mahendran R, Deivasigamani AP. A case of Y tubular duplication of the sigmoid colon in a pediatric patient. J Indian Assoc Pediatr Surg 2023;28:546-7

How to cite this URL:
Arunachalam P, Mahendran R, Deivasigamani AP. A case of Y tubular duplication of the sigmoid colon in a pediatric patient. J Indian Assoc Pediatr Surg [serial online] 2023 [cited 2023 Nov 28];28:546-7. Available from: https://www.jiaps.com/text.asp?2023/28/6/546/389318




A 6-year-old female patient was referred with intermittent colicky lower abdominal pain for 2 days with signs of incomplete obstruction. She had a history of similar complaints for 1 year. Abdominal examination revealed a nontender fecal mass in the right iliac fossa.

Plain abdominal X-ray showed a dilated loop with a crescentic level – fecal/air [Figure 1]a. Delayed phase contrast X-ray showed a blind loop arising from the sigmoid [Figure 1]b. Computed tomography abdomen was suggestive of a redundant sigmoid colon complicated by sigmoid volvulus [Figure 1]c.
Figure 1: (a) Plain erect abdominal X-ray showed a well-defined mottled right iliolumbar mass with an air-fluid level, along with grossly dilated large bowel loops, (b) delayed phase abdominal X-ray showing filling of mass with rectal contrast, with a blind dilated end suggesting that the duplication arose from the sigmoid colon, and (c) coronal view of computed tomography abdomen showing dilated bowel loops with impacted feces (red square). Largest loop diameter was ~ 8.5 cm

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Laparotomy showed a dilated 15 cm Y-shaped tubular duplication of sigmoid colon causing partial volvulus filled with impacted feces. Resection of the duplication with adjacent 2 cm of bowel with primary anastomosis was done [Figure 2]a, [Figure 2]b, [Figure 2]c. Histopathological examination confirmed the tubular duplication of the colon [Figure 3].
Figure 2: (a) A 15 cm Y tubular duplicated segment arising from the antimesenteric side of the sigmoid colon, (b) blood supply of the duplicated segment, and (c) resected duplicated segment

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Figure 3: 10x Mucosa (green asterisk) showed colonic epithelium with reactive changes and inflammatory cells in the lamina propria; Muscularis mucosa (blue asterisk) was hypertrophied; Submocosa (yellow asterisk) showed lymphoid hyperplasia

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The case is presented for its rarity and the diagnostic dilemma in imaging.

Acknowledgments

Dr. Jayaprakash and Dr. Amritha, Department of Radiology, PSG Institute of Medical Sciences and Research; Dr. Sakthisankari, Department of Patholgy, PSG Institute of Medical Sciences and Research.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.




    Figures

  [Figure 1], [Figure 2], [Figure 3]



 

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