Experience with gastro-intestinal duplications in childhood

Background: Intestinal duplications are rare congenital malformations. The different locations and sizes of these duplications require a specific diag nostic and surgical approach. This study reviews our paediatric patients wi th intestinal duplications in order to analyse the influence of prenatal so nography and laparoscopy on the clinical course. Patients and methods: Thir teen duplications of the alimentary tract in 12 patients have been treated over a 10-year period from 1989 to 1999. Six of our patients were diagnosed prenatally by ultrasound and were free of symptoms until surgery, except f or one patient who had meconium-ileus owing to cystic fibrosis. In another five patients, the diagnosis was made on the basis of symptoms with signs o f obstruction. In one child, the duplication was found incidentally during an operation for an anorectal malformation. The location of the 13 duplicat ions was the stomach in three eases, the duodenum in one case, the jejunum in two cases, the ileum in six cases and the rectum in one case. Laparotomy was performed in ten patients. Two cases were treated by laparoscopic-assi sted resection. Conclusion: Early diagnosis and treatment of uncomplicated intestinal duplications by means of prenatal sonographic screening and lapa roscopic-assisted resection, respectively, are desirable in this congenital malformation. Resection of the duplication with or without minimal resecti on of the adjacent normal intestine should be mandatory.