A rare diagnosis in the operation room: Kidney atrophy due to duplicated colon in an adult

Gastrointestinal congenital anomalies are rare entities in an adult patient. Commonly they are located in the upper gastrointestinal system and present with intestinal symptoms such as bleeding, obstruction and/or perforation of the intestine. One extraordinary case of colon duplication was recently reported in the January 28 issue of the World Journal of Gastroenterology because of its great significance in presenting with hydronephrotic atrophy of the right kidney, rather than gastrointestinal symptoms, in an adult. This article will undoubtedly be of interest to health professionals.

The article describes a male patient who presented to Dr. Sahin Kabay and Dr. Faik YAYLAK of Dumlupinar University Hospital, Turkey, in 2006. This patient was quite a challenge for Dr. Kabay and Dr. Yaylak. He was a 28-year-old man with a palpable mass in the right flank. He was undiagnosed for his intermittent complaints of right flank pain for several months.

The initial efforts were to treat and to control his urinary tract infection. At primary diagnostic imaging studies, Dr. Kabay and Dr. Yaylak noted the mass in the right flank with hydronephrosis of the right kidney. Their further efforts to clarify the origin of the mass with intravenous pyelography, scintigraphy and even colonoscopy were not enough to make a diagnosis pre-operatively. Computed tomography images demonstrated the continuum of the mass with the right colon. Dr. Kabay and his surgical team scheduled their patient for a laparotomy under general anesthesia. During the operation, the surgical team was excited to diagnose the double tubular colon as the cause of the pathological mass. The mass with duplicated colon and appendix was removed uneventfully. The postsurgical course of the patient was not significant and he recovered well over the following year.

In an effort to make a correct diagnosis in the patient, Dr. Kabay and Dr. Yaylak were forced to carry out a fine pre-operative diagnostic workup. However, only when an operation room became available were they able to make the final diagnosis of a rare congenital anomaly of the gastrointestinal system.

Reference: Kabay S, Yucel M, Yaylak F, Hacioglu A, Algin MC, Olgun EG, Sahin L, Aydin T. Combined duplication of the colon and vermiform appendix in an adult patient. World J Gastroenterol. 2008 Jan 28;14(4):641-643.
http://www.wjgnet.com/1007-9327/14/641.asp

Correspondence to: Faik Yaylak, MD, Assistant Professor, Dumlupinar Universitesi Hastanesi, Kutahya 43100, Turkey. faikyaylak@lycos.com
Telephone: +90-533-3386890 Fax: +90-274-2652277

World Journal of Gastroenterology (WJG), a leading international journal in gastroenterology and hepatology, has established a reputation for publishing first class research on esophageal cancer, gastric cancer, liver cancer, viral hepatitis, colorectal cancer, and H pylori infection and provides a forum for both clinicians and scientists. WJG has been indexed and abstracted in Current Contents/Clinical Medicine, Science Citation Index Expanded (also known as SciSearch) and Journal Citation Reports/Science Edition, Index Medicus, MEDLINE and PubMed, Chemical Abstracts, EMBASE/Excerpta Medica, Abstracts Journals, Nature Clinical Practice Gastroenterology and Hepatology, CAB Abstracts and Global Health. ISI JCR 2003-2000 IF: 3.318, 2.532, 1.445 and 0.993. WJG is a weekly journal published by WJG Press. The publication dates are the 7th, 14th, 21st, and 28th day of every month. WJG is supported by The National Natural Science Foundation of China, No. 30224801 and No. 30424812, and was founded with the name of China National Journal of New Gastroenterology on October 1, 1995, and renamed WJG on January 25, 1998.