Complete Communicating Tubular Oesophageal Duplication in an Adolescent Presenting With Haematemesis and Long-Standing Dysphagia

Complete communicating tubular oesophageal duplication is a rare congenital foregut anomaly that may remain undiagnosed until adolescence because symptoms can be intermittent. A 17-year-old boy with long-standing intermittent solid-food dysphagia presented with moderate haematemesis. Upper gastrointestinal endoscopy identified an ulcerated inflammatory stricture 26 cm from the incisors, an accessory orifice, and a diverticulum-like opening. Biopsies showed ulcerative and regenerative changes with glandular and intestinal metaplasia without dysplasia. Barium oesophagography and cervicothoracoabdominal computed tomography demonstrated chronic oesophageal dilatation and an anterior tubular structure running parallel to the thoracic oesophagus, with multiple communications to the native lumen and distal drainage towards the gastric cardia, without a tracheobronchial fistula. Repeat endoscopy with a paediatric gastroscope confirmed an accessory channel lined by oesophageal-type mucosa and draining into the stomach alongside a stenotic native lumen. Complete communicating tubular oesophageal duplication should be considered in patients with long-standing dysphagia and an accessory oesophageal opening. Diagnosis requires complementary endoscopic and radiological assessment, and management should be individualised through multidisciplinary review.