DUPLICATION OF THE GASTROINTESTINAL TRACT IN CHILDREN

Author:

Smirnov A. N.1,Gavrilenko Nadezhda V.2

Affiliation:

1. N.I. Pirogov Russian National Research Medical University; N.F. Filatov Children´s Municipal Hospital № 13

2. N.I. Pirogov Russian National Research Medical University

Abstract

Duplication of the gastrointestinal tract (GIT) being a rare malformation can be localized in anywhere of the digestive tube. The incidence of this disease is 1:4,500 newborns. In most cases doubling of the gastrointestinal tract is diagnosed before the age of two years and is found in both girls and boys with a slight predominance of boys. Duplications of the gastrointestinal tract are closely connected cystic or tubular structures possessing a common blood supply with any part of the digestive tract. Signs of doubling are a well-developed layer of smooth muscles in the wall of duplication and the presence of the mucous membrane. The type of mucosa of the formation generally corresponds to the gastrointestinal tract from which it originates but in 29-35% of cases ectopic tissue occurs. The spectrum of clinical symptoms of gastrointestinal redundancies is extremely diverse and often the diagnosis of the disease presents great difficulties for the surgeon. It depends on the type of duplication, location, size, the presence of ectopic mucosa and communication with the lumen of a healthy area of the digestive tract. At present, there is no consensus on the tactics of managing patients with GITduplication. The choice of the method of surgical treatment (enucleation, fenestration, resection) is determined by the following criteria: the localization and size of pathological formation, the mobility of the supporting segment of the digestive tube, the ratio to the lumen segment of the gastrointestinal tract (extra-, intraluminal position), the type of blood supply, the presence or absence of communication with the lumen of a healthy site of the gastrointestinal tract and the age of the patient. In each case of doubling, an individual approach and choice of tactics for surgical treatment are required. This article presents a literature review on the topic “Doubling the digestive tract in children” in details, there are highlighted theories of embryogenesis of this developmental defect, classifications, clinical features, diagnosis and surgical treatment of duplications of different localization.

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