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Sigmoid volvulus is a rare cause of intestinal obstruction in the pediatric age group. Rotation of the redundant sigmoid colon about its narrow mesenteric base results in vascular compromise and large bowel obstruction. Predisposing factors for sigmoid volvulus are Hirschsprung's disease, congenital anomalous fixation of the colon, and chronic constipation. Here, we report two cases of sigmoid volvulus in children with redundant sigmoid colon in the South Indian subcontinent. If it is not diagnosed in time, it may lead to serious complications such as gangrene, perforation, septic shock, and eventually death. Thus, the condition warrants prompt evaluation and treatment.
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BACKGROUND: A right-sided sigmoid colon is an extremely rare anatomic variation that should be considered as a possibility by surgeons and radiologists before surgery. Here, we report the first clinical case of a carcinoma in a right-sided sigmoid colon revealed by a preoperative computed tomography (CT). CASE SUMMARY: A 56-year-old Chinese man was admitted to the hospital with abdominal pain. CT revealed a redundant sigmoid colon with a mass on the right side of the cecum and ascending colon. Laparoscopy confirmed an abnormal course in the descending colon and sigmoid colon. Subsequently, hemicolectomy was performed in an open manner after laparoscopic exploration. Pathological examination revealed an infiltrative mucinous adenocarcinoma with two lymph node metastases. The patient was discharged without any complications after a week. There were no signs of recurrence or metastasis during the 3-month follow-up period. CONCLUSION: We report a rare anomaly of a right-sided sigmoid colon with carcinoma, which should be differentiated from ascending colon cancer and pericecal hernia to prevent errors and other surgical complications.
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Introduction Sigmoid colon constitutes a part of the large intestine that presents several congenital anatomic variations. In particular, the presence of a redundant loop of sigmoid colon is of tremendous importance for surgeons, obstetricians and radiologists, since it is closely related to multiple pathological conditions and functional implications of the neighboring anatomical structures. PRESENTATION OF CASE: An unusual anatomic variation in position and length of the sigmoid colon and its mesocolon was unexpectedly detected during right hemicolectomy to a 67-year-old Caucasian male patient due to colon cancer. The operation was uneventful. A meticulous review of the literature was conducted as well. DISCUSSION: A redundant loop of sigmoid colon may go unnoticed or it might lead to urinary, digestive and vascular complications. Its presence is associated with acute and chronic pathological conditions, sigmoid volvulus and serious confusions in radiological diagnosis and instrumentation. CONCLUSION: Surgeons' thorough knowledge concerning this rare anatomic variation is fundamental and crucial in order to establish a correct diagnosis and assert the appropriate management when performing operations including pelvis and abdomen.
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INTRODUCTION: Laparoscopic ventral mesh rectopexy (LVMR) has gained widespread acceptance for the management of complete rectal prolapse (CRP). However, there have been concerns considering its use in patients with a redundant sigmoid colon. This study was conducted to evaluate the anatomical and functional results following LVMR, particularly in cases of CRP with a redundant sigmoid colon. MATERIALS AND METHODS: Retrospective analysis of 25 patients who underwent LVMR from January 2011 to September 2016 was performed. Patients were divided into two groups according to the duration of follow-up. Group A (long-term) with follow-up >3 years and Group B (mid-term) <3 years. RESULTS: The study included 25 patients (M:F = 1.5:1) with a median age of 38 years. Eighty-eight percent of the patients had a redundant sigmoid colon. Significant improvement in post-operative Wexner score as compared to pre-operative values was seen in patients with pre-existing constipation (P < 0.0001). In patients presenting with faecal incontinence (FI), significant improvement in post-operative St. Mark's incontinence score was observed. Functional outcomes remain consistent in long-term follow-up (>3 years). CONCLUSIONS: LVMR seems to be a feasible surgical procedure with minimum morbidity and good long-term functional outcomes. It provides satisfactory results in patients with redundant sigmoid colon and improves pre-existing constipation and FI.
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Objective To investigate the diagnostic and therapeutic measurements for the disease of redundant sigmoid colon. Methods Twenty-two patients diagnosed as redundant sigmoid colon disease and received treatments were retrospectively analysed. Results Three of the 22 patients received conservative treatment with satisfactory efficacy (100. 00% ). Among the 19 patients who received surgical treatment, 17 have satisfactory efficacy (89. 47%). Conclusion For patients with intractable constipation, the possibility of redundant sigmoid colon should be considered. The diagnosis for this disease mainly depends on barium enema. Non-surgical treatment is prefered as first choice. Surgical procedure can be performed when conservative treatment fails. The indications of surgical treatment should be restrictly defined and a complete colon preparation is required before the operation.
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Objective To study the diagnosis and operative treatment of redundant sigmoid colon in children.Methods The length of sigmoid flexure was measured by enema examination in children with constipation,if it was over the normal scope,redundant sigmoid colon were come into existence.Twenty-three cases were treated by operated,hemicolectomy were done in 14 of 23 cases,others were treated by Soave′s procedure through transanal local excision.Results Symptoms disappeared completely in 18 of 23 cases and decreased in 5 cases.Nine cases were cured after Soave's procedure through transanal local excision.There were significant differences between 2 groups(P