Duplications of the Alimentary Tract in the Adult

Abstract

Duplications of the alimentary tract occur with sufficient frequency in the adult population to merit inclusion in the differential diagnosis of obscure causes for gastrointestinal symptoms. A total of 67 duplications in 63 patients have been reviewed, including 3 new cases described herein. Only 3 of these lesions were incidental autopsy findings. Fifty-seven patients were subjected to operation and corrective procedure carried out. Two patients died as a result of the operative procedure, and in both the duplication was extensive, involving both the esophagus and stomach. Duplications may be either spherical or tubular, or both, and occur anywhere from the mouth to the anus. In the present series, 26 originated from the esophagus, 9 from the stomach, 6 from the duodenum, 10 from the small intestine, 5 from the colon, 3 from the esophagus and stomach combined, and 2 from the small and large bowel, combined while in 2 patients multiple lesions existed in different parts of the alimentary tract. Symptoms such as chronic pain, dysphagia, dyspepsia, and complications, including bleeding, ulcération, perforation, bowel obstruction, and malignancy, may produce serious disability. Operative intervention is frequently the only adequate means of diagnosis. X-ray evaluation, including chest roentgenograms and barium studies of the intestinal tract, are valuable in locating the site of duplication; however, the exact diagnosis is seldom established prior to operation. It is probable that many of these lesions produce obscure chronic gastrointestinal symptoms, which defy accurate diagnosis, and frequently are labelled “functional bowel problems.” Once the diagnosis is established, adequate surgical correction, preferably complete removal, is the treatment of choice. © 1962 American Medical Association. All rights reserved.