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Orthotopic and age-appropriate sized anus with surrounding sphincter (asterisk) and a perineal fistula (arrow).
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Examination under anesthesia and electrostimulation confirmed an orthotopic and age-appropriate sized anus with surrounding sphincter and a perineal fistula ( Fig. 1 ).
Duplicated terminal ileum with a separated mesentery leading to two ceca (arrows) and appendices (asterisks).
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Exploratory laparotomy revealed a duplicated terminal ileum starting 10 cm proximal to the ileocecal valve with a separated mesentery leading to two ceca and appendices ( Fig. 2 ), which joined to a completely duplicated colon with a septum and common mesentery ( Fig. 3 ).
Division of the common colonic wall using a stapler to create one lumen up to the level of the ileocaecal valve.
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The common colonic wall was divided using a stapler to create one lumen up to the level of the ileocaecal valve ( Fig. 4 ).
(
A
and B) Mucosectomy (Soave plane) of the rectal duplication leading to the perineal fistula leaving its muscular cuff in place.
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Fig. 5A , B ). Finally, a protective ileostomy was created.