case_images: PMC11410600_01
case_images: The presentation, fistulogram, and intraoperative view of the ACD. (A) Accssory perineal opening with clear fluid discharge (arrow), perianal erosion, anal fissure ( ), and native stenosed anus ( ). (B) Lateral abdominal radiograph showing a contrast medium outlining a tubular duplication (pink arrows) without communication to the native anorectum (white arrows). (C) Removal of the tubular mucosa (arrow) via the perineal ( ) combined with coccygeal transverse approach.
case_images: fped-12-1452116-g001.jpg
case_images: PMC11410600_01_fped-12-1452116-g001.jpg
case_images: F1
case_images: Upon physical examination, a perineal orifice of 1.5 mm in diameter (Figure 1A) with clear and colorless fluid discharge, perianal erosion and superficial anal fissures was found on the posterior mid-line of the stenosed native anus. Contrast injection via both the abnormal orifice and the native stenosed anus revealed a 3- cm-long tubular tract with a blind end, not communicating with the native anorectal lumen (Figure 1B). After preoperative anal dilatation and mechanical bowel preparation, the mucosa in the duplicated anal canal was completely excised via a perineal approach combined with a small coccigeal transverse incision (Figure 1C) to avoid damage to the anal sphincter.
case_images: The pathologic findings of the ACD. Pathological findings of the specimen show a tubular structure lined by heterotopic gastric (fundic) mucosa, which consisted of parietal, chief, and mucous neck cells with smooth muscle fibers.
case_images: fped-12-1452116-g002.jpg
case_images: PMC11410600_01_fped-12-1452116-g002.jpg
case_images: F2