A Case of Laparoscopic Colon Fixation for Descending Colonic Volvulus Due to Persistent Descending Mesocolon

Abstract

The patient was a 15-year-old female who was diagnosed with intestinal obstruction after visiting a family doctor due to abdominal pain and distension. The patient was subsequently referred to our hospital. Our diagnosis was colon volvulus because of dilation of the right colon and the presence of a whirl sign on abdominal CT. Endoscopic detorsion of the colon was performed. In reconstructed 3D CT, the sigmoid colon ran along the midline of the abdomen and the descending colon was twisted 270º in a clockwise direction toward the organo-axis. The diagnosis was descending colon volvulus due to persistent descending mesocolon. Due to repeat torsions, a transanal ileus tube was inserted to decompress the intestines and prevent torsion, and elective laparoscopic fixation of the descending colon was performed. Adhesions were dissected between the sigmoid colon that ran along the midline and the mesentery of the small intestine. The left colon was sutured to the left abdominal wall to form the splenic flexure and S-D junction. There was no recurrence at 6 months after surgery. We report this case of laparoscopic colon fixation for descending colon volvulus due to persistent descending mesocolon with a review of the literature.