Tubular duplication of the esophagus. Contribution of magnetic resonance imaging in anatomical analysis before surgery

The authors report a tubular duplication of the thoracic esophagus in a 17- year-old male. This anomaly, rare in the adult, can be explained either by a failure of esotracheal compartmentalisation, or a notochordodysraphy or m ore probably by an error during vacuolisation of the esophagus. The anatomi cal characteristics of the duplication were clearly seen on MRI. This inves tigation showed the intramural duplication, with only a thin barrier withou t muscle, between the esophageal lumen and the duplication channel: two com munications were present between the esophageal lumen and the duplication. The esophagus was accessed by right thoracotomy. The close contact between the duplication and the esophagus did not allow them to be separated. A sub total esophagectomy was necessary, with digestive continuity being restored by coloplasty after a left cervicotomy and a laparotomy. The anatomy seen on the MRI should have predicted that an esophagectomy was necessary and th at a thoracotomy could have been avoided by performing the procedure with a closed thorax.