PMC9381362_01
Colostomy and prolapse mucus fistula (
A
). Three distinct lumens of the colostomy (
B
).
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The ostomy and mucus fistulas were matured ( Fig. 1 ) and the patient was referred to our center for further management. 
High-resolution three-dimensional imaging showing three colonic lumens of proximal colon, distal colon with one blind ending lumen, and one fistulizing to the bladder.
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High-resolution and three-dimensional contrast imaging demonstrated two lumens of the distal colon with one ending as a fistula to the bladder and the other blind ending ( Fig. 2 ).
Diagram of the operative findings.
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The colonic duplication continued all the way to the cecum ( Fig. 3 ).
PMC9381362_02
Intraoperative findings. Three colonic lumens of colostomy (
A
). Two colonic lumens of mucus fistula (
B
). Ileal, cecal, and appendiceal duplication (
C
). Entire colon with normal outer appearance despite multiple internal lumens (
D
).
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An ileal duplication and fused appendiceal duplication were also identified intraoperatively ( Fig. 4 ). A stapler was used to create a single lumen in the ascending and descending colons ( Fig. 4 ).