Anat Cell Biol.  2014 Dec;47(4):279-281. 10.5115/acb.2014.47.4.279.

Absence of transverse colon, persistent descending mesocolon, displaced small and large bowels: a rare congenital anomaly with a high risk of volvulus formation

• Shetty P
• Nayak SB

• KMID: 1882609
• DOI: http://doi.org/10.5115/acb.2014.47.4.279

Abstract

Congenital anomalies such as positional anomalies of the right half of the colon are more common when compared to its left half. We report a rare case of congenital anomaly where the transverse colon was totally absent. Ascending colon continued as descending colon at the right colic flexure. Ascending and descending colons formed an inverted U shaped loop which was situated in the right half of the abdomen. The sigmoid colon began from the descending colon, on the right side of the midline and coursed to the left iliac fossa. The terminal part of ascending colon and entire descending colon had a persistent mesocolon. The jejunum and ileum were situated in the upper left part of the abdominal cavity. This anomaly can cause volvulus of the colon at any stage of life. Furthermore, the knowledge of this anomaly is very useful for radiologists, gastroenterologists and surgeons.

Keyword

Transverse colon; Descending mesocolon; Jejunum

MeSH Terms

Abdomen
Abdominal Cavity
Colon
Colon, Ascending
Colon, Descending
Colon, Sigmoid
Colon, Transverse*
Ileum
Intestinal Volvulus*
Jejunum
Mesocolon*

Figure

• 

  Fig. 1 Undisturbed position of abdominal viscera after reflection of anterior abdominal wall. Greater omentum has been reflected upwards. Note the inverted U shaped loop of ascending and descending colons. Jejunum and ileum are occupying the upper left part of the abdomen and the sigmoid colon is crossing from right to left.

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  Fig. 2 Descending colon (DC) has been pulled to the left to show the descending mesocolon (DMC). Note the continuity of the descending mesocolon with the ascending mesocolon (AMC), and sigmoid mesocolon (SMC). Ascending colon (AC) and sigmoid colon (SC) are also seen.

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  Fig. 3 The descending colon (DC) has been pulled to the right to show the descending mesocolon (DMC). Note the ileum passing behind the prominent margin of the descending mesocolon. Sigmoid colon (SC) and sigmoid mesocolon (SMC) are also seen.

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  Fig. 4 A simplified illustration of the anomalies observed. The caecum (C), ascending colon (AC), ascending mesocolon (AMC), descending colon (DC), descending mesocolon (DMC), sigmoid colon (SC), sigmoid mesocolon (SMC), jejunum (JJ), and ileum (IL) have been labelled.

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