Duplications of the Alimentary Tract

Abstract

Alimentary tract duplications are rare congenital cystic or tubular malformations that are usually found adjacent to a segment of the gut, sharing a common wall but are occasionally located at a more distant site. They are usually single, variable in size, and characterized by a well-defined coat of smooth muscle and an epithelial lining consisting of some type of gut mucosa. They may be asymptomatic and discovered incidentally on physical examination or during imaging for unrelated conditions, e.g., at prenatal sonography. However, the majority cause symptoms, most often in early childhood, but sometimes not until adult life. Presenting symptoms and signs are related to the site and size of the duplication and whether it contains ectopic gastric mucosa, which predisposes to mucosal ulceration and bleeding. Various associated congenital anomalies have been reported, particularly vertebral anomalies. Duplication cysts should be excised completely to relieve symptoms and avoid the risk of complications, including malignant degeneration in adulthood. After complete excision, long-term outcome is generally excellent.