A Case of Ileal Duplication with Intestinal Hemorrhage

ABSTRACT

Duplications of the alimentary tract are uncommon congenital anomalies that usually present in childhood. They are cystic or tubular in shape, and composed of muscular walls with gastrointestinal mucosal lining. These lesions are almost invariably adjacent to the alimentary tract, most often found in the ileum, may communicate with the lumen, and may be multiple. We experienced an unusual case of a 18-month-old male patient who presented with intermittent blood-tinged stool as an initial manifestation of ileal duplication. The lesion was revealed by bleeding scan and Meckel's scan and was suspected to be a bleeding Meckel's diverticulum due to peptic ulceration of the ileum adjacent to the ectopic gastric mucosa. At laparotomy, a 3-cm-sized cystic mass communicating with the adjacent bowel lumen and multiple conglomerated lymph nodes were identified at the mesenteric side of the distal ileum. Resection of the lesion and adjacent ileum containing enlarged lymph nodes was done. In microscopic findings, the unilocular cystic structure lying in the mesenteric border showed an intestinal wall lined in part by gastric fundic mucosa with a small ulcer, especially at the blind end, and in part by small intestinal mucosa. Muscularis propria and serosa were also present.