Surgery for long tubular intestinal duplication with massive hemorrhage: a case report and literature review
Abstract Background Long tubular duplication is a rare congenital intestinal disease, that can lead to emergency situations marked by massive hemorrhage. However, preoperative diagnosis and surgical treatment are challenging. This report presents preoperative images and details a surgical procedure...
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| Format: | Article |
| Language: | English |
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Japan Surgical Society
2024-02-01
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| Series: | Surgical Case Reports |
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| Online Access: | https://doi.org/10.1186/s40792-024-01829-6 |
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| author | Chiyoshi Toyama Hiroto Mizushima Kenichi Kinjo Yohei Masunaga Yasuko Fujisawa Isao Miyairi Yukichi Tanahashi Satoshi Osawa Toshio Sawai |
| author_facet | Chiyoshi Toyama Hiroto Mizushima Kenichi Kinjo Yohei Masunaga Yasuko Fujisawa Isao Miyairi Yukichi Tanahashi Satoshi Osawa Toshio Sawai |
| author_sort | Chiyoshi Toyama |
| collection | DOAJ |
| description | Abstract Background Long tubular duplication is a rare congenital intestinal disease, that can lead to emergency situations marked by massive hemorrhage. However, preoperative diagnosis and surgical treatment are challenging. This report presents preoperative images and details a surgical procedure for long tubular intestinal duplications with massive hemorrhage. Case presentation A 3-year-old boy presented to the emergency department with melena. Despite undergoing a Tc-99m pertechnetate scintigraphy one year prior, which revealed nonspecific findings with enhancement of some parts of the intestine, enhanced abdominal CT revealed an edematous small intestine with luminal extravasation. The patient received a transfusion of red blood cells; however, his hemoglobin level did not improve. Arterial angiography and double-balloon endoscopy revealed no remarkable findings. Exploratory laparotomy revealed a long tubular duplication in half of the small intestine. Utilizing the Wrenn procedure, we successfully removed all duplicate mucosa. Pathological findings showed that almost all duplications contained gastric mucosa and revealed an ulcer with a ruptured arterial vessel. His symptoms were resolved, and the hemoglobin level stabilized. At 2 months postoperatively, no surgical complications were present. Conclusions Effective management of long tubular duplications with massive hemorrhage involves timely application of the Wrenn procedure. Recognition of specific imaging findings is crucial to prompt exploratory laparotomy, ensuring optimal outcomes and preventing delays in treatment. |
| format | Article |
| id | doaj-art-028123c236fb40dfb22da2400f95607d |
| institution | Kabale University |
| issn | 2198-7793 |
| language | English |
| publishDate | 2024-02-01 |
| publisher | Japan Surgical Society |
| record_format | Article |
| series | Surgical Case Reports |
| spelling | doaj-art-028123c236fb40dfb22da2400f95607d2025-08-20T03:32:47ZengJapan Surgical SocietySurgical Case Reports2198-77932024-02-011011610.1186/s40792-024-01829-6Surgery for long tubular intestinal duplication with massive hemorrhage: a case report and literature reviewChiyoshi Toyama0Hiroto Mizushima1Kenichi Kinjo2Yohei Masunaga3Yasuko Fujisawa4Isao Miyairi5Yukichi Tanahashi6Satoshi Osawa7Toshio Sawai8Department of Pediatric Surgery, Hamamatsu University School of Medicine, University HospitalDepartment of Pediatrics, Hamamatsu University School of Medicine, University HospitalDepartment of Pediatrics, Hamamatsu University School of Medicine, University HospitalDepartment of Pediatrics, Hamamatsu University School of Medicine, University HospitalDepartment of Pediatrics, Hamamatsu University School of Medicine, University HospitalDepartment of Pediatrics, Hamamatsu University School of Medicine, University HospitalDepartment of Radiology, Hamamatsu University School of Medicine, University HospitalDepartment of Endoscopic and Photodynamic Medicine, Hamamatsu University School of Medicine, University HospitalDepartment of Pediatric Surgery, Hamamatsu University School of Medicine, University HospitalAbstract Background Long tubular duplication is a rare congenital intestinal disease, that can lead to emergency situations marked by massive hemorrhage. However, preoperative diagnosis and surgical treatment are challenging. This report presents preoperative images and details a surgical procedure for long tubular intestinal duplications with massive hemorrhage. Case presentation A 3-year-old boy presented to the emergency department with melena. Despite undergoing a Tc-99m pertechnetate scintigraphy one year prior, which revealed nonspecific findings with enhancement of some parts of the intestine, enhanced abdominal CT revealed an edematous small intestine with luminal extravasation. The patient received a transfusion of red blood cells; however, his hemoglobin level did not improve. Arterial angiography and double-balloon endoscopy revealed no remarkable findings. Exploratory laparotomy revealed a long tubular duplication in half of the small intestine. Utilizing the Wrenn procedure, we successfully removed all duplicate mucosa. Pathological findings showed that almost all duplications contained gastric mucosa and revealed an ulcer with a ruptured arterial vessel. His symptoms were resolved, and the hemoglobin level stabilized. At 2 months postoperatively, no surgical complications were present. Conclusions Effective management of long tubular duplications with massive hemorrhage involves timely application of the Wrenn procedure. Recognition of specific imaging findings is crucial to prompt exploratory laparotomy, ensuring optimal outcomes and preventing delays in treatment.https://doi.org/10.1186/s40792-024-01829-6DuplicationTubularMelenaWrennGastric mucosa |
| spellingShingle | Chiyoshi Toyama Hiroto Mizushima Kenichi Kinjo Yohei Masunaga Yasuko Fujisawa Isao Miyairi Yukichi Tanahashi Satoshi Osawa Toshio Sawai Surgery for long tubular intestinal duplication with massive hemorrhage: a case report and literature review Surgical Case Reports Duplication Tubular Melena Wrenn Gastric mucosa |
| title | Surgery for long tubular intestinal duplication with massive hemorrhage: a case report and literature review |
| title_full | Surgery for long tubular intestinal duplication with massive hemorrhage: a case report and literature review |
| title_fullStr | Surgery for long tubular intestinal duplication with massive hemorrhage: a case report and literature review |
| title_full_unstemmed | Surgery for long tubular intestinal duplication with massive hemorrhage: a case report and literature review |
| title_short | Surgery for long tubular intestinal duplication with massive hemorrhage: a case report and literature review |
| title_sort | surgery for long tubular intestinal duplication with massive hemorrhage a case report and literature review |
| topic | Duplication Tubular Melena Wrenn Gastric mucosa |
| url | https://doi.org/10.1186/s40792-024-01829-6 |
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