WOFAPS 2025 8th World Congress of Pediatric Surgery

Shilpa Sharma ¹, Manish Jain ², Deepak Mittal ³, Praveen Mathur ⁴

¹ All India Institute of Medical Sciences, New Delhi, India
² SAACHI Children Hospital, Surat
³ Divydeep Children’s Surgical Hospital, Hissar
⁴ Department of Pediatric Surgery, Sawai Man Singh Medical College, Jaipur, India.

PURPOSE: Caudal Duplication Syndrome (CDS) is a rare and complex anomaly. Each case is unique and adds knowledge to the available literature

METHOD: A Prospective case series of caudal duplication syndrome are described.

RESULTS. All four cases of CDS had associated anorectal malformation. Of the 4 cases, 2 were females. Colostomy was done at birth for one girl with associated cloacal duplication and both boys with anorectal malformation. One boy with anorectal malformation with recto-bladder neck fistula associated cleft palate and Temporomandibular joint ankylosis, underwent abdominoperineal pull-through at 18 months of age along with removal of the harmatoma (cartilaginous tissue lined by mucosa) present between both the scrotal sacs. He expired after surgery due to respiratory failure with seizures. The other boy underwent excision of a prolapsing mass arising from between the two scrotal sacs that was a benign teratoma on histology. Both girls underwent complete repair with removal of the intervening lipomatous mass and approximation of the divaricated anal sphincters on either side. Postoperatively, both children were continent and could contract their rectum. During follow-up, one child developed secondary rectal ectasia (dilatation) due to anal stenosis for which anoplasty was done. Both children are continent at 6;13 years follow up.

CONCLUSION: CDS is a complex malformation requiring a planned treatment. The anal sphincter complex should be identified carefully during surgery and placed around the neoanus for the child to attain continence. Associated anomalies may account for mortality.