Gastrointestinal Duplication

Gastrointestinal duplications are rare congenital malformations that can vary in size, location, presentation and symptoms. They can be esophageal, gastric or intestinal in nature.

May be associated with: spinal abnormalities

Problems that may occur from duplications:

• Respiratory distress
• Abdominal pain or bleeding (either as vomiting or in stool)
• Vomiting, poor feeding, failure to thrive or palpable mass
• Ulceration or hemorrhage with or without pancreatitis
• Volvulus (twisting) causing obstruction of adjacent intestine
• Perforation
• Constipation, rectal bleeding

Treatment

• Surgical resection is the preferred method for treatment for most GI duplications
• The type and presentation of duplication will be evaluated by the surgeon and specific recommendations for treatment will be made

Surgery:

If possible, surgical resection is performed. In some cases, only the inner lining of the cyst is removed. If excision cannot be performed, drainage of the cystic area may be attempted. If gastric (stomach) acid producing lining is present, it must be excised to prevent future ulceration/perforation. Pre-operative work-up will determine how best to deal with the cyst.

• Esophageal: Surgical treatment almost always involves excision of the cyst
• Thoracic or thoracoabdominal: Surgical excision of the cyst. It may be necessary to remove in stages. Some of these may connect to the spine and require treatment of this connection as well.
• Gastric: Surgical excision of the cyst is necessary. Removal of large parts of the stomach is not usually required.
• Duodoneal: Surgical resection or drainage may be used in these complex cases that can involve the bile or pancreatic ducts.
• Small Intestine: Segmental resection along with the adjacent intestine is the most common approach. In the absence of gastric (stomach) lining , drainage may be accepted if resection is not an option. If very large, mucosal stripping may be performed.
• Colonic: A complete excision of the duplication cyst and normal colon is the most common treatment. 
• Rectal: Total excision is done if possible.