Pediatr Surg Int (2007) 23:919–921
DOI 10.1007/s00383-007-1908-8
CASE REPORT
Anterior colorectal duplication presenting as rectal prolapse
Amador Ramirez-Resendiz Æ Jose Asz Æ
F. Antonio Medina-Vega Æ J. Arturo Ortega-Salgado
Accepted: 7 March 2007 / Published online: 27 March 2007
Ó Springer-Verlag 2007
Abstract Duplications of the gastrointestinal (GI) tract
are rare. Only 5% of them are rectal and there are very few
reports of rectal prolapse (RP) caused by a duplication. An
11 month-old female presented with a RP caused by a
blind-ended anterior tubular colorectal duplication. The
duplication was successfully opened and connected to the
normal rectum without complications. Although infre-
quent, a rectal duplication should be considered in the
differential diagnosis of RP.
Keywords Colorectal duplication
Hindgut duplication

Rectal prolapse
Introduction
Gastrointestinal (GI) tract duplications are rare congenital
malformations. Most of them occur in the ileum and only
5% are seen in the rectum [1, 2]. Less than 100 cases of
rectal duplication have been reported in the literature and
the majority of these are located in the retro–rectal space
[1]. There are very few reports of a rectal duplication
presenting as rectal prolapse (RP) [2].
We report a rare case of an anterior colorectal tubular
duplication that presented as RP. Although infrequent, a
A. Ramirez-Resendiz
J. Asz
F. A. Medina-Vega

J. A. Ortega-Salgado
Department of General Surgery, National Institute of Pediatrics,
Mexico City, Mexico
J. Asz (&)
Departamento de Cirugı́a General, Instituto Nacional de
Pediatrı́a, Insurgentes Sur 3700-C, colonia Insurgentes
Cuicuilco, México D.F 04530, México
e-mail: jose_asz@yahoo.com
rectal duplication should be considered in the differential
diagnosis of RP.
Case report
An 11 month-old female presented with a 5-month history
of a mass protruding through the anus during defecation.
The mass was approximately 5 cm long, hard, red, and
reduced spontaneously. Stools were normal. On rectal
exam, the sphincter tone was preserved and there was no
blood. A 5-cm hard mass could be palpated anterior to the
rectum and prolapsed through the anus with gentle
manipulation (Fig. 1). A barium enema showed a double
tubular image from the descending colon to the rectum,
compatible with colorectal duplication (Fig. 2). A CT scan
confirmed that the tubular colorectal duplication started
and was communicated with the normal colon at the
descending segment, and ended blindly at the anal side
(Fig. 3). There were no genitourinary or vertebral anoma-
lies. The blind-ended pouch was opened transanally and the
petrified stools were evacuated from it (Fig. 4). The distal
portion of the duplication was communicated to the normal
rectum by dividing the common wall with a linear stapler
(Fig. 5). A piece of the duplication wall was sent to
pathology and showed normal rectal mucosa. The patient
had an uneventful recovery and was discharged 2 days
after the operation, defecating normally and without evi-
dence of RP.
Discussion
Colorectal duplication was first reported by Suppinger in
1876, and described extensively by Ravitch in 1953 [3].
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