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Posterior rectal duplication in a pediatric patient, an infrequent condition: Case report

Abstract:

Background: Duplications of the gastrointestinal tract are unusual congenital malformations of congenital origin that can imply from the base of the tongue to the anal canal, being observed more frequently at the ileum level (22%) and to a lesser extent at the rectal level with a 5%. Currently there are less than 100 reports in the world of rectal duplicity literature, with a predominance in the pediatric population, being infrequent in adulthood. The posterior sagittal atrophy (Peña technique) is the standard approach for anorectal malformations with a high percentage of resolution. Case report: We present the case of a 3-year-old girl who came to the clinic for the presence of a double perineal orifice. A contrast study was carried out and through the posterior anal orifice (ectopic) a pathway ending in the bottom of the caecum sac was observed, without passing to the rectal ampulla, with a length of approximately 3.3cm. Through the anterior hole corresponding to the anal orifice, evidence of communication between them and concomitant congenital malformations is ruled out. Evolution: The patient is admitted and corrective surgery of the defect is planned, with a minimum posterior sagittal anorectoplasty, Peña technique. The procedure is performed without complications and is discharged with a favorable evolution. The result of pathology confirms the diagnosis, being compatible with a tubular rectal duplicity. Conclusion: Rectal duplication is an infrequent pathology that is usually asymptomatic. The histopathology is confirmatory and the posterior sagittal approach is useful only when the length of the distal colon is adequate.