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...
Main Authors: | , , , , , , |
---|---|
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 |
id |
doaj-20b2a7a7e02a4fe7bc9594722e301154 |
---|---|
record_format |
Article |
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 |
work_keys_str_mv |
AT susanjehangir entericduplicationinchildrenexperiencefromatertiarycenterinsouthindia AT pradeepjosephninan entericduplicationinchildrenexperiencefromatertiarycenterinsouthindia AT tarunjohnjacob entericduplicationinchildrenexperiencefromatertiarycenterinsouthindia AT anueapen entericduplicationinchildrenexperiencefromatertiarycenterinsouthindia AT johnmathai entericduplicationinchildrenexperiencefromatertiarycenterinsouthindia AT rejujosephthomas entericduplicationinchildrenexperiencefromatertiarycenterinsouthindia AT sampathkarl entericduplicationinchildrenexperiencefromatertiarycenterinsouthindia |
_version_ |
1725795545391300608 |