Summarization of Diagnosis and Treatment of Adult Ileal Duplications_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

HUANG Xin , LI Binglu , ZHOU Jiaolin , XIAO Yi , ZHAO Yupei

Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medial Sciences, Beijing 100730, China;

Corresponding author：

Keywords：

Gastrointestinal duplication; Ileal duplication; Diagnosis; Therapy; Adult

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ObjectiveTo sum up the diagnosis and treatment of adult ileal duplication with clinical cases from Peking Union Medical College Hospital (PUMCH). MethodsSix cases of adult ileal duplication admitted in our hospital from February 1996 to December 2010 were analyzed. Different assistant investigations were supposed to different patients due to the chief complaints including gastroscope, colonoscopy, abdominal CT scan, arteriography, 99Tcm radionuclide imaging, and double-balloon intestinal endoscope. None was made a definite diagnosis before operation with only one uncertain case. All cases received operation and pathological examination. Results All cases admitted were male. The chief complaints included intestinal bleeding, abdominalgia, intestinal obstruction, and abdominal mass. Five out of six patients received gastroscope, colonoscopy, and abdominal CT scan while three received mesenteric arteriography, but none was found any suggestion for ileal duplication. Even 99Tcm radionuclide imaging pointed out only two with abnormal abdominal bleeding. Three received doubleballoon intestinal endoscope, paying attention that only one discovered with ileal duplication. In a concluding, none was made a definite diagnosis before operation with only one uncertain case. All the cases received operation. The duplications of ileum in the length of 6-25 cm were found at the site of 11-100 cm proximal to ileocecum during the operation. Pathological report confirmed the clinical diagnosis of all cases with adult ileal duplications． Two cases were found with ectopic gastric mucosa, another two with diverticulum, and one with ectopic pancreas， in addition the remaining with inflammatory fibrous pseudotumor. Prognosis were good for all after operation. ConclusionsIleal duplications are rarely seen in adults, gender prefer male． Without specific clinical symptoms and inspections, definite diagnosis before operation is hard to make. But maybe doubleballoon intestinal endoscope and 99Tcm radionuclide imaging can give out positive result. Surgeons should be aware of this condition when performing abdominal exploration. Once discovered, resection is necessary.

Citation： HUANG Xin,LI Binglu,ZHOU Jiaolin,XIAO Yi,ZHAO Yupei,.. Summarization of Diagnosis and Treatment of Adult Ileal Duplications. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2011, 18(11): 1200-1204. doi: Copy

1.	徐春岳. 6例成人肠重复畸形诊治体会 [J]. 临床医学， 2002, 22(2)： 2627.
2.	Johnson JA 3rd, Poole GV. Ileal duplications in adults. Presentation and treatment [J]. Arch Surg, 1994, 129(6): 659661.
3.	毛一雷，朱峰，杜顺达，等. 成人回肠重复畸形的诊断和治疗 [J]. 中国临床营养杂志, 2006, 14(5)： 300302.
4.	Hackam DJ, Zalev A, Burnstein M, et al. Enteric duplication in the adult, derived from the foregut, midgut and hindgut: presentation, patterns and literature review [J]. Can J Surg, 1997, 40(2): 129133.
5.	Azzie G, Beasley S． Diagnosis and treatment of foregut duplications [J]. Semin Pediatr Surg， 2003, 12(1)： 4654．.
6.	赵玉元. 肠重复畸形合并急性并发症的诊断与治疗 [J]. 中华胃肠外科杂志， 2007， 10（2）: 114.
7.	Ladd AP, Grosfeld JL. Gastrointestinal tumors in children and adolescents [J]. Semin Pediatr Surg, 2006, 15(1): 3747.
8.	赵玉元. 64例肠重复畸形的外科治疗 [J]. 临床小儿外科杂志， 2007, 6(2): 1214.
9.	Chen CC， Yeh DC， Wu CC， et al． Huge cystic duplication of the ascending colon in adult [J]． Zhonghua Yi Xue Za Zhi (Taipei)， 2001, 64(3): 174178.
10.	Kim SK， Lim HK， Lee SJ， et al． Completely isolated enteric duplication cyst： case report [J]． Abdom Imaging, 2003, 28(1): 1214．.
11.	Daudet M, Chappuis JP, Daudet N． Symposium on intestinal duplications [J]． Ann Chir Infant， 1967， 8(1): 580.
12.	Iyer CP, Mahour GH． Duplications of the alimentary tract in infants and children [J]． J Pediatr Surg, 1995, 30（9）: 12671270.
13.	Puligandla PS， Nguyen LT， StVil D， et al． Gastrointestinal duplications [J]． J Pediatr Surg， 2003, 38(5)： 740744．.
14.	秦高平，王小强，迟达超，等. 成人小肠重复畸形致消化道出血1例 [J]．陕西医学杂志， 2007, 36 (2): 255256.
15.	彭颖，王立新，张能维，等. 成人回肠重复畸形溃疡穿孔伴多重畸形一例 [J]. 中华普通外科杂志， 2005， 20（10： 659660.
16.	李巍，冀明，张澍田. 成人回肠重复畸形合并消化道出血1例 [J]．胃肠病学， 2010, 15(6): 383384.
17.	李承念. 成人回肠重复畸形并急性阑尾炎一例 [J]．临床外科杂志， 2009, 17(2): 87.
18.	Hwang IK， Namkung S， Kim BS， et al． Perforated ileal duplication cyst with haemorrhagic pseudocyst formation [J]． Pediatr Radiol, 2003, 33(7)： 489491．.
19.	Ogino H, Ochiai T, Nakamura N, et al. Duplication cyst of the small intestine found by doubleballoon endoscopy: a case report [J]． World J Gastroenterol， 2008， 14(24): 39243926.
20.	岑晓红, 李爱美, 钱振育. 双气囊电子小肠镜26例分析 [J]. 中国误诊学杂志, 2009, 9(1): 197198.
21.	AlSarem SA, AlShawi JS. Ileal duplication in adults [J]． Saudi Med J， 2007， 28(11): 17341736.

1. 徐春岳. 6例成人肠重复畸形诊治体会 [J]. 临床医学， 2002, 22(2)： 2627.
2. Johnson JA 3rd, Poole GV. Ileal duplications in adults. Presentation and treatment [J]. Arch Surg, 1994, 129(6): 659661.
3. 毛一雷，朱峰，杜顺达，等. 成人回肠重复畸形的诊断和治疗 [J]. 中国临床营养杂志, 2006, 14(5)： 300302.
4. Hackam DJ, Zalev A, Burnstein M, et al. Enteric duplication in the adult, derived from the foregut, midgut and hindgut: presentation, patterns and literature review [J]. Can J Surg, 1997, 40(2): 129133.
5. Azzie G, Beasley S． Diagnosis and treatment of foregut duplications [J]. Semin Pediatr Surg， 2003, 12(1)： 4654．.
6. 赵玉元. 肠重复畸形合并急性并发症的诊断与治疗 [J]. 中华胃肠外科杂志， 2007， 10（2）: 114.
7. Ladd AP, Grosfeld JL. Gastrointestinal tumors in children and adolescents [J]. Semin Pediatr Surg, 2006, 15(1): 3747.
8. 赵玉元. 64例肠重复畸形的外科治疗 [J]. 临床小儿外科杂志， 2007, 6(2): 1214.
9. Chen CC， Yeh DC， Wu CC， et al． Huge cystic duplication of the ascending colon in adult [J]． Zhonghua Yi Xue Za Zhi (Taipei)， 2001, 64(3): 174178.
10. Kim SK， Lim HK， Lee SJ， et al． Completely isolated enteric duplication cyst： case report [J]． Abdom Imaging, 2003, 28(1): 1214．.
11. Daudet M, Chappuis JP, Daudet N． Symposium on intestinal duplications [J]． Ann Chir Infant， 1967， 8(1): 580.
12. Iyer CP, Mahour GH． Duplications of the alimentary tract in infants and children [J]． J Pediatr Surg, 1995, 30（9）: 12671270.
13. Puligandla PS， Nguyen LT， StVil D， et al． Gastrointestinal duplications [J]． J Pediatr Surg， 2003, 38(5)： 740744．.
14. 秦高平，王小强，迟达超，等. 成人小肠重复畸形致消化道出血1例 [J]．陕西医学杂志， 2007, 36 (2): 255256.
15. 彭颖，王立新，张能维，等. 成人回肠重复畸形溃疡穿孔伴多重畸形一例 [J]. 中华普通外科杂志， 2005， 20（10： 659660.
16. 李巍，冀明，张澍田. 成人回肠重复畸形合并消化道出血1例 [J]．胃肠病学， 2010, 15(6): 383384.
17. 李承念. 成人回肠重复畸形并急性阑尾炎一例 [J]．临床外科杂志， 2009, 17(2): 87.
18. Hwang IK， Namkung S， Kim BS， et al． Perforated ileal duplication cyst with haemorrhagic pseudocyst formation [J]． Pediatr Radiol, 2003, 33(7)： 489491．.
19. Ogino H, Ochiai T, Nakamura N, et al. Duplication cyst of the small intestine found by doubleballoon endoscopy: a case report [J]． World J Gastroenterol， 2008， 14(24): 39243926.
20. 岑晓红, 李爱美, 钱振育. 双气囊电子小肠镜26例分析 [J]. 中国误诊学杂志, 2009, 9(1): 197198.
21. AlSarem SA, AlShawi JS. Ileal duplication in adults [J]． Saudi Med J， 2007， 28(11): 17341736.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Summarization of Diagnosis and Treatment of Adult Ileal Duplications

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