The Small Intestinal Duplications in Children

The small intestinal duplication is rare congenital malformation that may vary greatly in presentation, size, location, and symptom. Objective: To review the clinical presentation, etiopathogeny and treatment modalities, through our observations and an overview of literature. Study Design: retrospective chart review including twenty observations of duplications of the jejuno-ileum collided between 2000 and 2015 in Monastir department of pediatric surgery. Medical charts were examined for clinical presentation and treatment modalities. Results: Our cohort was 20 children (11 male, 9 female) with small intestinal duplication with a median age of 10 months (ranged from 1 day to 4 years). The clinical features were polymorphous but remained dominated by a digestive symptomatology. The abdominal ultrasound was conducted in 18 patients and made a significant contribution to the diagnosis by showing in 12 cases pictures of cystic with double tunic strongly suggestive of the diagnosis. All our patients were operated, an open surgical procedure was undertaken in 75% of the cases, where a laparoscopic assisted procedure for a first look was practiced in 25% of cases. The surgical treatment consisted in a total mass resection with an end-to-end anastomosis in 15 patients, where enucleation of the cystic mass was undertaken in 4 patients. In one patient, the excision of the duplication was subtotal and the residual mucosa was peeled off. The postoperative recoveries were uneventful in 85% of the patients. The average follow-up was 2 years and 8 months; it was satisfying in all cases. Conclusion: The small intestinal duplication is a rare congenital lesion. Surgical resection must be undertaken before the occurrence of the complications.