An Adult Patient with an Acute Abdomen Caused by Strangulated Intestinal Duplication

Abstract

Duplication of the gastrointestinal tract is a congenital disorder that can occur anywhere in the gastrointestinal tract and present with a variety of abdominal symptoms. This congenital disorder is usually discovered during early childhood and is relatively rarely found in adults. Strangulated intestinal duplication has seldom been reported, and preoperative diagnosis is difficult. An adult patient with strangulation of duplicated intestine who presented with an acute abdomen is reported along with a discussion of the relevant literature.
A 33-year-old man developed colicky pain after eating lunch. Later that night, he had severe abdominal pain and vomiting, and he was evaluated in an emergency department. Abdominal contrast CT at the time of arrival showed dilated small bowel in the lower abdominal midline with proximal intestinal strangulation. The patient was diagnosed with strangulation ileus, and an urgent laparotomy was performed.
At 210 cm from the ligament of Treitz, normal intestine crossed the duplicated intestine, and at this branch point, there was clockwise rotation of 720° with ischemia. A partial small bowel resection, including the intestinal duplication, was performed. The patient had a satisfactory postoperative course and was discharged 4 days after surgery.