TL;DR
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An infant treated for constipation and suspected bowel obstruction was found to have a rare duplication of the colon and rectum. Surgeons connected the duplicated and native colons rather than removing one, because they shared blood supply; the child was reported to be doing well a year later.
An infant taken to hospital with abdominal distention, vomiting and constipation was found to have a rare duplication of the colon and rectum, according to a case report in BMJ Case Reports. Surgeons joined the two colons rather than removing the duplicated section, because it shared a blood supply with the normal colon.
The child was first assessed in an emergency department, where clinicians suspected a partial bowel obstruction, and was transferred to a specialist pediatric surgical center. There, clinicians used several imaging methods to clarify the anatomy. A CT scan with 3D reconstruction showed two separate colonic channels leading to one anal canal, with no other anomalies identified.
The surgical team confirmed the duplication during an open abdominal operation. The duplicated colon was heavily impacted with stool and shared a wall and a single mesentery with the native colon. The case authors said removing the duplicated section could have put the blood flow to the entire colon at risk. Instead, surgeons divided the shared wall to connect the two channels.
The report says the infant recovered quickly, tolerated feeding through the digestive tract and left hospital on the seventh day after surgery. A barium enema six weeks later showed normal colonic anatomy with some remaining dilation. The child’s ileostomy was reversed 10 weeks after surgery. One year later, the child was reported to be growing well and passing soft stool daily, sometimes with stool softeners.
Why the Anatomy Changed Surgery
The case highlights why the cause of severe or persistent symptoms can matter as much as treating the symptoms themselves. The report says the child had multiple earlier interactions with health professionals, with episodes attributed to ordinary constipation. The discovery of a duplicated bowel altered the surgical plan: because the two colons shared blood supply, removing one could have harmed the other.
This is a case report, not evidence that constipation generally points to a rare anatomical condition. Its practical significance, as described by the clinicians, is the value of reviewing a child’s history and investigating marked abdominal distention or other concerning features rather than assuming every episode has the same cause. The team also credited collaboration between pediatric surgery and radiology with helping them map the anatomy before operating.
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A Rare Digestive Tract Duplication
Duplications of the alimentary canal can occur anywhere from the mouth to the anus. The case authors cite an estimated frequency of about one in 4,500 births for alimentary canal duplications overall; they report that colonic duplications make up 13% to 15% of those cases. More than 80% of alimentary tract duplications present before a child’s second birthday, according to the authors.
A duplication involving the entire colon is described in the report as extremely rare in infancy, with only a few cases reported in the United Kingdom. The child’s parents also described green stools for four to five months and said they had raised concerns, but were reassured that the color could be normal. They said in a note accompanying the report that they later viewed this as an indicator of an underlying problem. Stool color alone, however, does not establish the diagnosis; the anatomical finding in this case was confirmed through imaging and surgery.
““Everyone just attributed it to straightforward constipation without stopping to think, why? Is there something else going on?””
— Lynn Sinitsky, MBBS, West Hertfordshire Teaching Hospitals NHS Trust, speaking to MedPage Today
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Long-Term Bowel Function Still Needs Follow-Up
The report describes a positive outcome through one year, but it does not establish the child’s lifelong bowel function or provide longer-term follow-up. The child intermittently needs stool softeners, and the authors report some residual colonic dilation on imaging six weeks after surgery. They said long-term functional outcomes were anticipated to be favorable, but that is an expectation rather than a confirmed result.
The report also cannot establish how often green stools or constipation signal an anatomical abnormality in other children. It describes one rare case, and the available account does not provide evidence for using stool color alone to diagnose a bowel duplication.
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Monitoring After the Operation
The case report says the child continues to have a normal bowel habit, with occasional use of stool softeners, and no further concerns reported about abdominal distention, appetite or growth at the time of the account. Continued clinical follow-up will show whether that progress is sustained as the child grows. The report does not specify a future appointment schedule or describe additional planned procedures.
For readers, the development is a reminder that this case’s outcome depended on identifying unusual anatomy and planning surgery around its shared blood supply. The authors’ account supports careful evaluation when symptoms are pronounced or persistent, but it does not suggest that most childhood constipation has this rare cause.
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Key Questions
What did doctors find in the infant?
Imaging and surgery confirmed a duplication of the colon and rectum: two colonic channels descended toward a single anal canal. The report says no other anomalies were identified.
Why did surgeons connect the colons instead of removing one?
The duplicated and native colons shared a wall and a single mesentery, which carries blood vessels. The authors said removing the duplicated section could have jeopardized blood flow to the entire colon, so surgeons divided the shared wall to connect the channels.
How was the child doing after surgery?
The report says the child was discharged on the seventh day after surgery, later had the ileostomy reversed, and was reported to be thriving one year after the operation. The child passed soft stool daily and sometimes needed stool softeners.
Does this case mean constipation usually indicates a bowel duplication?
No. This is a report of a rare anatomical finding in one infant, not evidence that constipation usually signals a duplication. The case authors focused on the child’s marked symptoms and the need to investigate the underlying cause.
Source: rss
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