Duplications of the alimentary tract

Abstract

Duplications of the alimentary tract are cystic or tubular structures most often in close proximity with a section of the alimentary tract. The most common location is abdomen and the most common location is small intestine. Duplications possess a surrounding muscular layer, an inside mucosal layer, intrinsic nerves and peristalsis. Approximately 10% of duplications are multiple and there is a high prevalence of coexisting malformations of vertebral column, intestines and urinary tract and genitals. A diagnosed duplication should always warrant for search of others and the coexisting malformations. Duplications may contain heterotropic gastric or other kind of mucosa. Duplications are increasingly often diagnosed antenatally. One third of foregut and midgut duplications present during infancy whereas hindgut duplications without an external sign of duplicated anus or genitalia may remain undiagnosed longer. In an infant the most common symptom is vomiting from gastric outlet obstruction by a large cystic duplication, alternatively duplication may cause intestinal volvulus or intussusception. Duplications in the mouth, oropharynx, neck and thorax may cause airway obstruction. Heterotropic gastric mucosa in duplication may ulcerate and cause haemorrhage or perforation. Because of the risk of significant complications and the risk of eventual malignant transformation surgical removal of duplication is practically always indicated.