Gastrointestinal Duplications Workup

  • Author: Amulya K Saxena, MD, PhD; Chief Editor: Harsh Grewal, MD, FACS, FAAP   more...
 
Updated: Apr 10, 2012
 

Imaging Studies

The most common investigative methods used to image duplications are ultrasonography and contrast-medium examinations. However, computed tomography and magnetic resonance imaging can be helpful in difficult cases that require a multiplanar approach.[12]

Thoracic duplications are often apparent on routine chest radiography.[13] They have a characteristic enhancing ring that can be revealed by CT scanning.

Contrast studies are helpful in demonstrating the mass effect and displacement of normal alignment.[14, 15]

In cases of gastrointestinal bleeding, heterotopic gastric lining can be detected using technetium scans.[16]

CT scanning may be useful in the diagnosis of duodenal duplications.[17]

Ultrasonography has been successfully used in diagnosing duplications.[18, 19, 20] In cases of colonic or presacral duplications, ultrasonography has the added benefit of revealing associated genitourinary anomalies.

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Diagnostic Procedures

  • In most children with intestinal duplications, the diagnosis is not made before surgery.
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Contributor Information and Disclosures
Author

Amulya K Saxena, MD, PhD  Associate Professor, Department of Pediatric and Adolescent Surgery, Medical University of Graz, Austria

Amulya K Saxena, MD, PhD is a member of the following medical societies: Austrian Society for Pediatric and Adolescent Surgery, European Pediatric Surgeons Association, German Society of Pediatric Surgery, German Society of Surgery, International Pediatric Endosurgery Group, and Tissue Engineering and Regenerative Medicine International Society (TERMIS)

Disclosure: Nothing to disclose.

Specialty Editor Board

Rebeccah Brown, MD  Associate Director of Trauma Services, Associate Professor, Department of Clinical Surgery and Pediatrics, Cincinnati Children's Hospital Medical Center and University of Cincinnati Hospital

Rebeccah Brown, MD is a member of the following medical societies: American College of Surgeons, American Medical Association, and American Medical Women's Association

Disclosure: Nothing to disclose.

Mary L Windle, PharmD  Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose.

Deborah F Billmire, MD  Associate Professor, Department of Surgery, Indiana University Medical Center

Deborah F Billmire, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Pediatrics, American College of Surgeons, American Pediatric Surgical Association, Phi Beta Kappa, and Society of Critical Care Medicine

Disclosure: Nothing to disclose.

H Biemann Othersen Jr, MD  Professor of Surgery and Pediatrics, Emeritus Head, Division of Pediatric Surgery, Medical University of South Carolina

H Biemann Othersen Jr, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Pediatrics, American Association for the Surgery of Trauma, American Burn Association, American Cancer Society, American College of Surgeons, American Medical Association, American Pediatric Surgical Association, American Society for Parenteral and Enteral Nutrition, American Surgical Association, American Thoracic Society, British Association of Paediatric Surgeons, Society for Surgery of the Alimentary Tract, Society of Critical Care Medicine, South Carolina Medical Association, Southeastern Surgical Congress, Southern Medical Association, Southern Society for Pediatric Research, and Southern Thoracic Surgical Association

Disclosure: Nothing to disclose.

Chief Editor

Harsh Grewal, MD, FACS, FAAP  Clinical Professor of Surgery, Temple University School of Medicine; Chief, Division of Pediatric Surgery, Cooper University Hospital

Harsh Grewal, MD, FACS, FAAP is a member of the following medical societies: American Academy of Pediatrics, American College of Surgeons, American Pediatric Surgical Association, Association for Surgical Education, Children's Oncology Group, Eastern Association for the Surgery of Trauma, International Pediatric Endosurgery Group, Society of American Gastrointestinal and Endoscopic Surgeons, Society of Laparoendoscopic Surgeons, and Southwestern Surgical Congress

Disclosure: Nothing to disclose.

References

  1. Yang MC, Duh YC, Lai HS, et al. Alimentary tract duplications. J Formos Med Assoc. May 1996;95(5):406-9. [Medline].

  2. Shah A, More B, Buick R. Pyloric duplication in a neonate: a rare entity. Pediatr Surg Int. Mar 2005;21(3):220-2. [Medline].

  3. Iyer CP, Mahour GH. Duplications of the alimentary tract in infants and children. J Pediatr Surg. Sep 1995;30(9):1267-70. [Medline].

  4. La Quaglia MP, Feins N, Eraklis A, Hendren WH. Rectal duplications. J Pediatr Surg. Sep 1990;25(9):980-4. [Medline].

  5. Stern LE, Warner BW. Gastrointestinal duplications. Semin Pediatr Surg. Aug 2000;9(3):135-40. [Medline].

  6. Nagar H. Duplications of the gastrointestinal tract. Isr Med Assoc J. Dec 1999;1(4):254-6. [Medline].

  7. Barlev DM, Weinberg G. Acute gastrointestinal hemorrhage in infancy from gastric duplication: imaging findings. Emerg Radiol. Feb 2004;10(4):204-6. [Medline].

  8. Brown RL, Azizkhan RG. Gastrointestinal bleeding in infants and children: Meckel's diverticulum and intestinal duplication. Semin Pediatr Surg. Nov 1999;8(4):202-9. [Medline].

  9. Puligandla PS, Nguyen LT, St-Vil D, et al. Gastrointestinal duplications. J Pediatr Surg. May 2003;38(5):740-4. [Medline].

  10. Nobuhara KK, Gorski YC, La Quaglia MP, Shamberger RC. Bronchogenic cysts and esophageal duplications: common origins and treatment. J Pediatr Surg. Oct 1997;32(10):1408-13. [Medline].

  11. Kumar A, Kumar J, Gadodia A, Chumber S, Aggarwal L. Multiple short-segment colonic duplications. Pediatr Radiol. May 2008;38(5):567-70. [Medline].

  12. Hur J, Yoon CS, Kim MJ, Kim OH. Imaging features of gastrointestinal tract duplications in infants and children: from oesophagus to rectum. Pediatr Radiol. Jul 2007;37(7):691-9. [Medline].

  13. Pinter AB, Schubert W, Szemledy F, et al. Alimentary tract duplications in infants and children. Eur J Pediatr Surg. Feb 1992;2(1):8-12. [Medline].

  14. Berrocal T, Torres I, Gutierrez J, et al. Congenital anomalies of the upper gastrointestinal tract. Radiographics. Jul-Aug 1999;19(4):855-72. [Medline].

  15. Hur J, Yoon CS, Kim MJ, Kim OH. Imaging features of gastrointestinal tract duplications in infants and children: From oesophagus to rectum. Pediatr Radiol. Jul 2007;37(7):691-9. [Medline].

  16. Macpherson RI. Gastrointestinal tract duplications: clinical, pathologic, etiologic, and radiologic considerations. Radiographics. Sep 1993;13(5):1063-80. [Medline].

  17. Jayaraman MV, Mayo-Smith WW, Movson JS, et al. CT of the duodenum: an overlooked segment gets its due. Radiographics. Oct 2001;21 Spec No:S147-60. [Medline].

  18. Faigel DO, Burke A, Ginsberg GG, et al. The role of endoscopic ultrasound in the evaluation and management of foregut duplications. Gastrointest Endosc. Jan 1997;45(1):99-103. [Medline].

  19. Kuo HC, Lee HC, Shin CH, et al. Clinical spectrum of alimentary tract duplication in children. Acta Paediatr Taiwan. Mar-Apr 2004;45(2):85-8. [Medline].

  20. Segal SR, Sherman NH, Rosenberg HK, et al. Ultrasonographic features of gastrointestinal duplications. J Ultrasound Med. Nov 1994;13(11):863-70. [Medline].

  21. Karnak I, Ocal T, Senocak ME, Tanyel FC, Buyukpamukcu N. Alimentary tract duplications in children: report of 26 years' experience. Turk J Pediatr. Apr-Jun 2000;42(2):118-25. [Medline].

  22. Stringer MD, Spitz L, Abel R, et al. Management of alimentary tract duplication in children. Br J Surg. Jan 1995;82(1):74-8. [Medline].

  23. Ildstad ST, Tollerud DJ, Weiss RG, et al. Duplications of the alimentary tract. Clinical characteristics, preferred treatment, and associated malformations. Ann Surg. Aug 1988;208(2):184-9. [Medline].

 
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Jejunal duplication in a newborn. Intraoperative image demonstrates a cystic structure found on the antimesenterial side of the jejunum. A segmental resection was performed and the jejunum anastomosed.
 
 
 
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