A CASE OF ILEO-CAECAL DUPLICATION DETECTED AFTER APPENDECTOMY

This paper describes a recent experience with duplication of ileo-caecal alimentary tract in a 37-year-old man. The patient complained of persistent right lower abdominal pain even after appendectomy for acute appendicitis. Ultrasonography and CT scan revealed a cystic lesion which was about 5 cm in diameter on ileo-caecal location. Under a suspicion of duplication of alimentary tract, the patient was operated on. Cystic mass was adjacent to the ileum on the mesenteric side of ileum end. Ileo-caecal resection was done. Histological examination revealed that the cystic mass possessed the common proper muscle layer with ileum, and had ectopic gastric mucosa. By definition, the duplication of alimentary tract means such conditions that is encapsulated with one or more smooth muscle layers; that the inside is covered with digestive epitherium; and that is adjacent to the original digestive organ and shares the common smooth muscle layer. About 400 cases of alimentary tract duplication have been reported in Japan so far. Two cases out of 9000 newborn and infant autopsies had alimentary tract duplication in the USA. This disease is seen in all ages, but about 70% of the cases are seen in infants.