Duplications of the gastrointestinal tract

Abstract Duplications can occur anywhere in the alimentary canal. They may be cystic or tubular, are intimately attached to the adjacent intestine, and have a well-defined muscular wall and an epithelial lining related to some part of the gastrointestinal tract, not necessarily to the adjacent part. The foregut is affected in 36% (the oesophagus in 19%), the midgut in 50%, and the hindgut in 12%. Cystic duplications may be seen on prenatal ultrasound scan and usually present with obstruction to the adjacent intestine. Tubular duplications may present with bleeding due to heterotopic gastric mucosa (20%). The diagnosis can be suspected on plain X-ray, whereas ultrasound will show a thick-walled cystic lesion. Treatment is by excision (enucleation or resection with adjacent intestine) or in long tubular duplications by removal of the lining mucosa and establishing adequate distal drainage.