Relevance of a Persistent Descending Mesocolon to Sigmoid Volvulus

Atsushi Tsuruta, Yusaku Watanabe, Yasuo Oka, Minoru Fujita, Hiroshi Matsumoto, Yoshinori Fujiwara, Akiko Shiotani and Tomio Ueno

Department of Digestive Surgery, Kawasaki Medical School, Japan
Department of Internal Medicine, Kawasaki Medical School, Japan

^*Correspondance to: Atsushi Tsuruta 

 PDF  Full Text DOI: 10.25107/2474-1647.2188

Abstract

Purpose: Sigmoid Volvulus (SV) causes acute abdomen, but its mechanism of torsion still remains unknown. Persistent Descending Mesocolon (PDM) is a congenital anomaly where the primitive dorsal mesocolon fails to fuse with the parietal peritoneum in the 4th to the 5th month of gestation. We evaluated the association of PDM with SV.Materials and
Methods: We conducted a retrospective study of 45 consecutive patients (male: female=36:9, median age=77.8 years old) with SV who were treated at our hospital between 2009- 2016. Relationships among computed tomography findings (Coffee Bean sign (CB), Bird Beak sign (BB), Whirl Sign (WS), and PDM), anamnesis, a history of endoscopic treatment, and grading of pathological findings were analyzed.Results: The ratio of PDM in SV cases was higher compared with the usual frequency of occurrence. With regard to the grade of pathological findings, Univariate analysis showed significant differences in PDM and the number of endoscopic treatments. Multivariate analysis showed that only PDM was an independent factor for a low grading of inflammation of the colon.
Conclusion: PDM may be one of the causes of SV and should be one of determining factors of surgery for SV.

Keywords

Sigmoid volvulus; Persistent descending mesocolon; Coffee bean sign; Bird beak sign; Whirl sign

Cite the article

Tsuruta A, Watanabe Y, Oka Y, Fujita M, Matsumoto H, Fujiwara Y, et al. Relevance of a Persistent Descending Mesocolon to Sigmoid Volvulus. Clin Surg. 2018; 3: 2188.