Three’s a crowd, according to the saying, and this is especially true of sigmoid colons in an infant.

This nine-month-old patient had previously undergone the first two stages of surgical correction for anal atresia and a rectourethral fistula.

He was admitted to the paediatric surgical ward at the Central Child Teaching Hospital, Baghdad, for an elective closure of his divided sigmoidostomy.

It was after releasing the distal stoma that the doctors discovered three distinct bowel lumens or “tubular triplication of the distal sigmoid”.