Colonic Duplication

Etiology: Abnormal budding of gastrointestinal tract lined with gastrointestinal epithelium which may communicate with enteric lumen proper
Imaging: Can be cystic or tubular
Imaging US: Cystic lesion with echogenic rim sign = enteric signature (gut signature) = hyperechoic inner layer of cyst representing bowel mucosa
DDX: Ovarian cyst, mesenteric cyst, omental cyst
Complications: May cause obstruction, intussusception, bleeding, small bowel volvulus
Treatment: Elective surgical removal
Clinical: 15% of gastrointestinal duplications

Radiology Cases of Colonic Duplication

Barium enema of colonic duplication — Injection through the vagina (left) shows a normal caliber colon which is malpositioned with the descending colon on the right side of the abdomen and the cecum in the left lower quadrant. Injection through the rectum (right) shows a second colon of normal caliber that was again malpositioned. There was no communication between the two colons.

CT of colonic duplication — Axial CT with IV and oral contrast of the abdomen show a large midline mass which appears to contain air and stool (and no oral contrast) that extends from the lower abdomen (top) all the way to the rectum which it displaces posteriorly and to the right (bottom).

Clinical Cases of Colonic Duplication

Clinical image of colonic duplication — Clinical image shows a normal anus and a probe in an extra orifice in the posterior vaginal wall which communicates with the second colonic lumen.

Surgery Cases of Colonic Duplication

Surgical image of colonic duplication — Surgical image shows the duplicated colon at the level of the sigmoid colon with the two colonic lumens running side by side. The mucosa was removed from the duplicated colon from the level of its sigmoid colon to the vaginal orifice. The duplicated colon was then anastomosed to the normal colon at the level of the normal colon’s sigmoid colon.