case_images: PMC11832099_01
case_images: (a) Ultrasonogram of the perineal mass with double rim enhancing bowel loops, (b) contrast enema with a narrowed anorectum. (c) Coronal section of contrast-enhanced computed tomography with pelvic supernumerary kidney and perineal mass. CT: Computed tomography
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case_images: PMC11832099_01_JIAPS-30-107-g001.jpg
case_images: jiaps_169_24-f001
case_images: Postnatal ultrasound [Figure 1a] of the pelvis and the mass showed a defect in the pelvic diaphragm through which a structure with a gut signature was seen herniating in the midline anterior to the sacrum and coccyx. A contrast enema [Figure 1b] showed a narrow caliber rectum for about 4 cm proximal to which it was normally distended. A contrast-enhanced computed tomography [Figure 1c] was done which showed a well-defined lobulated sac along the vestibule with the presence of enhancing bowel loops within it.
case_images: (a) Preoperative image showing urethral, vaginal, and rectal lumen located anterior to the mass along with the abnormal external genitalia development, (b) intraoperative image showing the duplication cyst (held with forceps), anorectum (feeding tube with silk sutures), and their junction (metal probe)
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case_images: jiaps_169_24-f002
case_images: A 7 cm x 5 cm pedunculated, irregular, multilobulated, and firm mass [Figure 2a] was seen arising in the midline between the coccyx and the anteriorly displaced anus. On exploration in the prone position, the mass was seen arising from the posterior wall of the rectum with no luminal connection [Figure 2b].
case_images: (a) Stratified lining epithelium of duplication cyst in contiguity with rectal mucosa (H and E, x100), (b) perineum at the second follow-up
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case_images: The excised mass was sent for the pathological examination which showed a cystic structure with intestinal histomorphology, colonic epithelial lining, irregular, poorly developed muscularis layer, and dense transmural inflammatory infiltrate with marked serositis, confirming the diagnosis of rectal duplication cyst [Figure 3a]. She is doing well on follow-up [Figure 3b] at 3 months of age and is planned for colostomy closure.