Skip to main content Skip to main navigation menu Skip to site footer

Complete tubular duplication of colon presenting as rectovestibular fistula: A case report

  • Muntadhar Muhammad Isa ,
  • Amir Thayeb ,
  • Maria Meildi ,
  • Muhammad Bayu Zohari Hutagalung ,


Background: Duplication of the gastrointestinal tract is a rare congenital disorder in pediatric patients.  Complete resection in case of a total tubular duplication that requires total or subtotal colectomy is undesirable in children.

Case Presentation: This case presented a simple surgical technique for treating complete colonic duplication without colonic resection. A 2 months old female baby with abdominal distention and stool complaint came out from her vaginal vestibular and normal anus. A digital rectal exam showed a palpable mass in the posterior region. Abdominal CT Scan showed a rounded mass with size 2x2 cm in the left posterolateral of rectum region. The initial diagnosis was suspected sacrococcygeal tumor type 4 with rectovestibular fistula. Intraoperative findings showed duplication of the caecum, appendix, total colon (ascending to sigmoid) and rectum (one directed to the vagina and the other to anus). The ileostomy was done 20 cm from the ileocaecal junction as a temporary treatment to relieving distention with definitive repair planned in the following months. The second stage repair was performed after 1-year-old with posterosagital anorectoplasty followed by distal separation of the duplicated colon using a 12 cm linear stapler. For this case, the third stage repair was done one year after the previous surgery to close the remaining ileostomy. The patient’s outcome showed good results with normal defecating function and no complication.

Conclusion: Complete tubular duplication is a rare case without specific clinical symptoms, but the assessment of the diagnosis can be assisted by radiology such as abdominal CT and barium enema. We hope this article could illustrate management for complete tubular duplication of colon presenting as rectovestibular fistula, thus reflect how important clinical judgment and initial diagnostic in our health care system.


  1. Puligandla PS, Nguyen LT, St-Vil D, Flageole H, Bensoussan AL, Nguyen V-H, et al. Gastrointestinal duplications. J Pediatr Surg. 2003;38(5):740–4. Available from:
  2. Jellali MA, Mekki M, Saad J, Zrig A, Elanes I, Mnari W, et al. Perinatally discovered complete tubular colonic duplication associated with anal atresia. J Pediatr Surg. 2012;47(6):e19–23. Available from:
  3. Al-Shanafey S, Martin HCO, Bottger S. Colonic Duplication: Diagnostic Dilemma. Eur J Pediatr Surg. 2006;16(1):58–60. Available from:
  4. Kekez T, Augustin G, Hrstic I, Smud D, Majerovic M, Jelincic Z, et al. Colonic duplication in an adult who presented with chronic constipation attributed to hypothyroidism. World J Gastroenterol. 2008;14(4):644. Available from:
  5. Merrot T, Anastasescu R, Pankevych T, Tercier S, Garcia S, Alessandrini P, et al. Duodenal Duplications. Clinical Characteristics, Embryological Hypotheses, Histological Findings, Treatment. Eur J Pediatr Surg. 2006;16(1):18–23. Available from:
  6. Kabay S, Yucel M, Yaylak F, Hacioglu A, Algin MC, Olgun EG, et al. Combined duplication of the colon and vermiform appendix in an adult patient. World J Gastroenterol. 2008;14(4):641. Available from:
  7. Bhatnagar V, Bhadoo D, Chand K, Jana M, Gupta A. Colonic duplication: Treatment by limited division of common wall. J Indian Assoc Pediatr Surg. 2015;20(3):146. Available from:
  8. Castejón-Casado J, Muñoz Miguelsanz MA, Diaz Em, Gomez Mg, Padilla Garcia MA, Valade Rf. Acute abdomen secondary to complete tubular colonic duplication. J Indian Assoc Pediatr Surg. 2014;19(3):166. Available from:
  9. Sengar M, Gupta CR, Jain V, Mohta A. Colorectal duplication with prostatorectal fistulae. J Pediatr Surg. 2013;48(4):869–72. Available from:
  10. Singh S, Ahmed I, Rawat J, Panday A. Association of anorectal malformation with duplicated colon, sacral meningomyelocele and scrotal anomalies. Case Reports. 2011;2011(jul27 1):bcr1220103632–bcr1220103632. Available from:
  11. LETELIER M A, BARRÍA M C, BELTRÁN S MA, MORENO CH C. Duplicación intestinal: Diagnóstico y tratamiento de una condición inusual. Rev Chil cirugía. 2009;61(2). Available from:
  12. Kothari PR, Shankar G, Gupta A, Rastogi A, Kulkarni B. Multiple tubular and cystic intestinal duplications. Indian J Gastroenterol Off J Indian Soc Gastroenterol. 2004;23(6):224–5.
  13. Yousefzadeh DK, Bickers GH, Jackson JHJ, Benton C. Tubular colonic duplication--review of 1876-1981 literature. Pediatr Radiol. 1983;13(2):65–71.
  14. Brunschwig A, Dargeon H, Russell W. Duplication of the entire colon and lower ileum, with termination of one colon into a vaginal anus. Surgery. 1948;24(6):1010.
  15. Sarpel U, Le MN, Morotti RA, Dolgin SE. Complete colorectal duplication. J Am Coll Surg. 2005;200(2):304–5.
  16. Yucesan S, Zorludemir U, Ocay I. Complete duplication of the colon. J Pediatr Surg. 1986;21:962–3.

How to Cite

Isa, M. M., Thayeb, A., Meildi, M., & Hutagalung, M. B. Z. (2021). Complete tubular duplication of colon presenting as rectovestibular fistula: A case report. Bali Medical Journal, 10(2), 526–528.




Search Panel

Muntadhar Muhammad Isa
Google Scholar
BMJ Journal

Amir Thayeb
Google Scholar
BMJ Journal

Maria Meildi
Google Scholar
BMJ Journal

Muhammad Bayu Zohari Hutagalung
Google Scholar
BMJ Journal