Caudal Duplication Syndrome: the Vital Role of a Multidisciplinary Approach and Staged Correction

Abstract

Caudal duplication syndrome is a rare entity that describes the association between congenital anomalies involving caudal structures and may have a wide spectrum of clinical manifestations. A full-term male presented with combination of anomalies including anorectal malformation, duplication of the colon and lower urinary tract, split of the lower spine, and lipomyelomeningocele with tethering of the cord. We report this exceptional case of caudal duplication syndrome with special emphasis on surgical strategy and approach combining all disciplines involved. The purpose of this report is to present the pathology, assessment, and management strategy of this complex case.

Keywords

caudal duplication syndrome - anorectal malformation - rectal duplication - colonic duplication - genitourinary duplication

• References

• 1 Dominguez R, Rott J, Castillo M, Pittaluga RR, Corriere Jr JN. Caudal duplication syndrome. Am J Dis Child 1993; 147 (10) 1048-1052
• 2 Acer T, Ötgün İ, Sağnak Akıllı M, Gürbüz EE, Güney LH, Hiçsönmez A. A newborn with caudal duplication and duplex imperforate anus. J Pediatr Surg 2013; 48 (5) E37-E43
• 3 Bajpai M, Das K, Gupta AK. Caudal duplication syndrome: more evidence for theory of caudal twinning. J Pediatr Surg 2004; 39 (2) 223-225
• 4 Jellali MA, Mekki M, Saad J , et al. Perinatally discovered complete tubular colonic duplication associated with anal atresia. J Pediatr Surg 2012; 47 (6) e19-e23
• 5 Kekez T, Augustin G, Hrstic I , et al. Colonic duplication in an adult who presented with chronic constipation attributed to hypothyroidism. World J Gastroenterol 2008; 14 (4) 644-646
• 6 Fuchs JR, Clark K, Breckler FD, Rescorla FJ. Complete colonic duplication—a case report. J Pediatr Surg 2008; 43 (6) E11-E13
• 7 Gross GW, Wolfson PJ, Pena A. Augmented-pressure colostogram in imperforate anus with fistula. Pediatr Radiol 1991; 21 (8) 560-562
• 8 Hong AR, Acuña MF, Peña A, Chaves L, Rodriguez G. Urologic injuries associated with repair of anorectal malformations in male patients. J Pediatr Surg 2002; 37 (3) 339-344
• 9 Capasso G, Maffulli N. Dorsolumbar spine duplication. Acta Orthop Belg 1992; 58 (3) 343-345
• 10 Yiğit H, Özdemir HM, Yurduseven E. Duplication of spine with hemi-lipomyelomeningocele. Eur Spine J 2013; 22 (Suppl. 03) S487-S490
• 11 Incesu L, Karaismailoglu TN, Selcuk MB. Neurologically normal complete asymmetric lumbar spine duplication. AJNR Am J Neuroradiol 2004; 25 (5) 895-896
• 12 Cebesoy O, Mete A, Karsli B. Complete lumbar spine duplication in a neurologically intact man. J Spinal Cord Med 2009; 32 (1) 99-102
• 13 Abrahamson J. Double bladder and related anomalies: clinical and embryological aspects and a case report. Br J Urol 1961; 33: 195-214
• 14 Wisenbaugh ES, Palmer BW, Kropp BP. Successful management of a completely duplicated lower urinary system. J Pediatr Urol 2010; 6 (3) 315-317
• 15 Malone PS, Ransley PG, Kiely EM. Preliminary report: the antegrade continence enema. Lancet 1990; 336 (8725): 1217-1218
• 16 VanderBrink BA, Cain MP, Kaefer M, Meldrum KK, Misseri R, Rink RC. Split-appendix technique for simultaneous appendicovesicostomy and appendicocecostomy. J Pediatr Surg 2011; 46 (1) 259-262