Intestinal Duplication

(See also Overview of Congenital Gastrointestinal Anomalies.)

Duplications can be cystic or tubular depending on their length.

Intestinal duplications are uncommon, occurring in just 1 in 4500 live births (1). Males appear to be more commonly affected. Approximately one third of affected children have associated congenital anomalies of the gastrointestinal or urinary tract. Colonic duplication is often associated with anomalies of the urogenital system. Vertebral defects are also common.

The etiology of intestinal duplications is unknown. Theories include abnormalities in recanalization, a vascular insult, persistence of embryonic diverticula, and partial twinning. The lining of these duplications most commonly resembles the adjacent portion of the gastrointestinal tract, but it can be heterotopic and contain gastric or pancreatic mucosa.

The most common site of duplication is the jejunum and ileum followed by the esophagus, stomach, duodenum, and colon. Intestinal duplications usually manifest in the 1st or 2nd year of life.

Duplications can be asymptomatic or cause obstructive symptoms, chronic pain, gastrointestinal bleeding, or abdominal mass (2). Those in the chest can cause respiratory symptoms or feeding issues. Duplications containing heterotopic gastric or pancreatic mucosa can result in perforation.

If they are detected, treatment of intestinal duplications is surgical with complete resection of the duplicated portion. For proximal lesions, an endoscopic approach can be considered when a highly skilled endoscopist is available.