Surgery of the Duplication of the Intestines

Surgery of the Duplication of the Intestines is the removal of duplication.

July 21, 2022

Surgery of the Duplication of the Intestines is the removal of duplication.

Some facts about Surgery of the Duplication of the Intestines:

  • Intestinal duplications can be cystic or tubular depending on their length.
  • Intestinal duplications are uncommon, and males appear to be more commonly affected.
  • Abnormalities in recanalization, persistence of embryonic diverticula, a vascular insult, and partial twinning can be a cause of Intestinal duplications.
  • Mostly, the lining of these duplications resembles with the adjacent portion of the gastrointestinal tract.
  • But it can be heterotopic and contain gastric or pancreatic mucosa.
  • The jejunum and ileum followed by the esophagus, stomach, duodenum, and colon are the most common site of duplication.
  • Intestinal duplications usually occurs in the first or second year of life.
  • Intestinal duplications can be either asymptomatic or can cause obstructive symptoms, chronic pain, gastrointestinal bleeding, or abdominal mass.
  • Perforation can be a result if the duplications contain heterotopic gastric or pancreatic mucosa.
  • Treatment of intestinal duplications is surgical with complete resection of the duplicated portion if they are detected,
  • Intestinal duplications are usually diagnosed as an intestinal anomaly on prenatal ultrasonography.
  • Abdominal pain and/or a mass are the most common symptoms of intestinal duplications.
  • Small cystic duplications can result in localized volvulus or act as a lead point for small bowel intussusception.
  • Duplication can lead to compression of the adjacent intestine and cause obstructive symptoms if it enlarges or swells.
  • Most often this happens if the duplication is tubular and has a proximal communication with the bowel. 

Preparation for Surgery of the Duplication of the Intestines:

  • Avoid eating and drinking anything eight hours before Surgery of the Duplication of the Intestines.
  • You mare allowed to drink a sip of water with your medications if needed.
  • Any history of bleeding disorders or are taking any blood-thinning medicines, aspirin, or or nonsteroidal anti-inflammatory medications that affect blood clotting should be informed to your healthcare provider as you may need to stop taking these medicines before your surgery.
  • The possible complications and side effects, the risks, and what the operation involves  will be discussed with you by your doctor.
  • A medical history, including a history of previous bleeding will be taken by your doctor.
  • A physical exam will also be conducted.
  • Usually an operation is undertaken for correct diagnosis of a duplication.

Procedure for Surgery of the Duplication of the Intestines:

  • The preferred method of treatment for most gastrointestinal (GI) duplications is surgical resection.
  • However, surgical resection is inadvisable for duodenal duplications because of the close proximity of such cysts to the biliary and pancreatic ductal system.
  • A surgical approach may not be required in patients presenting with complex tubular colonic duplications if internal communication of the duplication is adequate and the colon is normal.
  • Surgical removal of duplication is usually accomplished by excising the duplication with its adjacent bowel with primary reanastomosis in the case of cystic duplications which can be done either by open or by laparoscopic technique.
  • Laparoscopy may also be an useful complement to open operation to diagnose these lesions and to allow for decompression of large lesions  to do an open resection through a much smaller incision.
  • It is advisable to thoroughly inspect the length of the intestine at the time of operation because of the high incidence of multiple lesions in these patients. 
  • Duplications in association with intestinal atresia, would present in the newborn period.
  • Infants who have diagnosed with duplications on prenatal ultrasonography do not need to undergo resection in the neonatal period unless they present with bowel obstruction.
  • Resection should be done within a few months to avoid complications such as obstruction or volvulus.
  • Ectopic gastric mucosa should be removed if present, either by limited resection or by mucosal stripping as this can lead to bleeding or perforation.