Enteric duplication in children: Experience from a tertiary center in South India

Background: Enteric duplications (EDs) are rare aberrations of the embryonic gut. This study was undertaken to define the clinical characteristics and management challenges of this unusual entity in the Indian population. Materials and Methods: Hospital records of 35 children with 38 ED operated bet...

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Main Authors: Susan Jehangir, Pradeep Joseph Ninan, Tarun John Jacob, Anu Eapen, John Mathai, Reju Joseph Thomas, Sampath Karl
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2015-01-01
Series:Journal of Indian Association of Pediatric Surgeons
Subjects:
Online Access:http://www.jiaps.com/article.asp?issn=0971-9261;year=2015;volume=20;issue=4;spage=174;epage=178;aulast=Jehangir
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spelling doaj-20b2a7a7e02a4fe7bc9594722e3011542020-11-24T22:15:12ZengWolters Kluwer Medknow PublicationsJournal of Indian Association of Pediatric Surgeons0971-92611998-38912015-01-0120417417810.4103/0971-9261.164246Enteric duplication in children: Experience from a tertiary center in South IndiaSusan JehangirPradeep Joseph NinanTarun John JacobAnu EapenJohn MathaiReju Joseph ThomasSampath KarlBackground: Enteric duplications (EDs) are rare aberrations of the embryonic gut. This study was undertaken to define the clinical characteristics and management challenges of this unusual entity in the Indian population. Materials and Methods: Hospital records of 35 children with 38 ED operated between 2003 and 2014 were analyzed and followed up. Results: The median age at presentation was 285 days (range 1-day to 16 years) with male preponderance (71%). Small bowel duplications were the most common (44%), and thoracoabdominal duplications were seen in 8% children compared to 2% in the literature. The median duration of symptoms was 18 days (interquartile range [IQR] 3-210 days). Associated anomalies were seen in 49% children with vertebral and spinal anomalies being the most common. Ultrasonogram (US) was done in 83% children and had a sensitivity of 55%. In the presence of a gastrointestinal bleed, Technetium 99m pertechnetate scintigraphy scan had a positive predictive value of 80%. Thirty-five lesions were completely removed. Mucosectomy was done in two children, and one total colonic duplication was left in situ after providing adequate internal drainage. There was no postoperative mortality. The follow-up was possible in 66% children. Conclusions: EDs are uncommon and have varied, nonspecific symptoms. Thoracoabdominal duplications are more common in the Indian population. The US is a good screening tool but requires a high index of suspicion where complete excision is not possible; the provision of adequate internal drainage is an acceptable alternative. The long-term prognosis of children with ED depends on the extent of physiological disturbance due to associated anomalies.http://www.jiaps.com/article.asp?issn=0971-9261;year=2015;volume=20;issue=4;spage=174;epage=178;aulast=JehangirAlimentary tract duplicationectopic gastric mucosaenteric duplication
collection DOAJ
language English
format Article
sources DOAJ
author Susan Jehangir
Pradeep Joseph Ninan
Tarun John Jacob
Anu Eapen
John Mathai
Reju Joseph Thomas
Sampath Karl
spellingShingle Susan Jehangir
Pradeep Joseph Ninan
Tarun John Jacob
Anu Eapen
John Mathai
Reju Joseph Thomas
Sampath Karl
Enteric duplication in children: Experience from a tertiary center in South India
Journal of Indian Association of Pediatric Surgeons
Alimentary tract duplication
ectopic gastric mucosa
enteric duplication
author_facet Susan Jehangir
Pradeep Joseph Ninan
Tarun John Jacob
Anu Eapen
John Mathai
Reju Joseph Thomas
Sampath Karl
author_sort Susan Jehangir
title Enteric duplication in children: Experience from a tertiary center in South India
title_short Enteric duplication in children: Experience from a tertiary center in South India
title_full Enteric duplication in children: Experience from a tertiary center in South India
title_fullStr Enteric duplication in children: Experience from a tertiary center in South India
title_full_unstemmed Enteric duplication in children: Experience from a tertiary center in South India
title_sort enteric duplication in children: experience from a tertiary center in south india
publisher Wolters Kluwer Medknow Publications
series Journal of Indian Association of Pediatric Surgeons
issn 0971-9261
1998-3891
publishDate 2015-01-01
description Background: Enteric duplications (EDs) are rare aberrations of the embryonic gut. This study was undertaken to define the clinical characteristics and management challenges of this unusual entity in the Indian population. Materials and Methods: Hospital records of 35 children with 38 ED operated between 2003 and 2014 were analyzed and followed up. Results: The median age at presentation was 285 days (range 1-day to 16 years) with male preponderance (71%). Small bowel duplications were the most common (44%), and thoracoabdominal duplications were seen in 8% children compared to 2% in the literature. The median duration of symptoms was 18 days (interquartile range [IQR] 3-210 days). Associated anomalies were seen in 49% children with vertebral and spinal anomalies being the most common. Ultrasonogram (US) was done in 83% children and had a sensitivity of 55%. In the presence of a gastrointestinal bleed, Technetium 99m pertechnetate scintigraphy scan had a positive predictive value of 80%. Thirty-five lesions were completely removed. Mucosectomy was done in two children, and one total colonic duplication was left in situ after providing adequate internal drainage. There was no postoperative mortality. The follow-up was possible in 66% children. Conclusions: EDs are uncommon and have varied, nonspecific symptoms. Thoracoabdominal duplications are more common in the Indian population. The US is a good screening tool but requires a high index of suspicion where complete excision is not possible; the provision of adequate internal drainage is an acceptable alternative. The long-term prognosis of children with ED depends on the extent of physiological disturbance due to associated anomalies.
topic Alimentary tract duplication
ectopic gastric mucosa
enteric duplication
url http://www.jiaps.com/article.asp?issn=0971-9261;year=2015;volume=20;issue=4;spage=174;epage=178;aulast=Jehangir
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