ANATOMIC VARIATION OF INTESTINAL TRACT (SMALL INTESTINAL TUBULAR DUPLICATION INFREQUENT SOURCE OF INTESTINAL OBSTRUCTION IN CHILDREN)
Background: Intestinal tract duplications are infrequent congenital abnormalities. The common perinatal demonstration is an abdominal lump. When its occurs in upper gastrointestinal tract has accompanying respiratory manifestation, but duplications in the lower gastrointestinal tract can present clinically as an intestinal obstruction, perforation, nausea, Vomiting, bleeding of lower GIT, or may be symptomless, or known as a related clinical manifestation. Eighty five percent of intestinal tract are identified in children under two years of age. These anomalies can be seen along the whole gastrointestinal tract from the esophagus to the lower end part of anus, but mostly occurs in ileum, and frequently has seen as a cystic lesion at the mesenteric border of the intestine but rarely tubular duplication can be occurred. The best way to approach is the surgical resection and anastomosis.
Materials and Methods: During the laparotomy in the Nangarhar Regional hospital Jalalabad in the department of General surgery. we find a 12-years-old patient with small bowel (ileum) tubular duplication. In spite of physical exam and imaging investigations, the diagnosis we made during laparotomy. Our current research has done in Nangarhar Reginal Hospital General Surgery Department from 2021-Jan to 2021-May.
Findings: Amongst Patients who admitted to Nangarhar Regional Hospital due to Peritonitis, we observed 1 case of the
Small intestinal duplication the patient was severely ill and also experienced weight loss during this period of time he received deferent medical treatments. The pain was sited in the periumbilical and lower abdominal quadrants. He cited month ago, He had a history of melena and diarrhea. The patient’s abdominal Physical exam was atypic unless he has mild abdominal distention and severe tenderness in the lower quadrants of abdominal wall. Lab exams reveal leukocytosis 13000/mm3, 36% hematocrit, platelets 400000 and C Reactive Protein of 2 milligram/Liter, and biochemical laboratory investigation revealed unchanged. Abdominal erect position X-ray reveals free air in peritoneal cavity. Ultrasound shows free fluid in abdominal cavity.
Conclusion: We believe that we always remember the duplication of intestinal tract for unexplained and unclear Diagnostic finding. Because of the very bad prognosis and complications from the intestinal duplication like obstruction, hemorrhage, volvulus, and peritonitis.
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