Complete colonic duplication in an infant.

A second exploratory laparotomy in our unit revealed duplication of entire colon up to the lower rectum. The terminal ileum was seen to enter the normal large bowel and the three parallel appendices were attached to the duplication, which was on the anterior side. We found that the duplication did not communicate with the normal bowel at the distal end by injecting saline into its distal end while it was clamped proximally. A distal communica­ tion was created by inserting a long crushing clamp via the anus with one limb in the rectum and the other limb in the duplication through an opening made into it via the rectum, to crush the septum between the normal bowel and duplication, so that the duplication would drain distally in to the rectum