Excision of a rectal duplication cyst in proximity to the glomus coccygeum - An unusual cause of intraoperative bleeding: A case report.

introductionRectal duplication cysts are rare congenital anomalies, accounting for approximately 4 % of all gastrointestinal duplication cysts. The glomus coccygeum is a vascular structure located around the tip of the coccyx. This case report details an adolescent female with a rectal duplication cyst, where incidental dissection of the glomus coccygeum during surgery resulted in unexpected blood loss. PRESENTATION OF CASE: A 19-year-old female with a history of anal transposition surgery for an imperforate anus and rectoperineal fistula as a newborn presented to the clinic with a four-month history of an enlarging posterior perianal mass with intermittent drainage. Magnetic Resonance Imaging showed a cystic structure, consistent with a congenital duplication cyst. She subsequently underwent excision of the congenital duplication cyst. A tubular cystic structure approximately 6 × 2.5 cm in diameter was present in the superior perianal area draining gray-brown fluid. Surprisingly, there was about 400 cc of blood loss during excision. An incidental finding of a glomus body, consistent with a glomus coccygeum, was found during pathological examination. DISCUSSION: Rectal duplication cysts account for around 1 to 8 % of alimentary duplications. Mistaken for a glomus tumor, the glomus coccygeum is a glomus body found around the tip of the coccyx.

conclusionRectal duplication cysts are rare congenital anomalies that require careful excision due to their proximity to the glomus coccygeum. Although the glomus coccygeum is infrequently encountered, it is important for surgeons to be familiar with this anatomical structure to minimize the risk of unexpected bleeding.