Trebješanin Zoran, Babić Srdjan, Vučurević Goran, Popov Petar, Ilijevski Nenad, Blagotić Milena
Srp Arh Celok Lek. 2012 Sep-Oct;140(9-10):637-40. doi: 10.2298/sarh1210637t.
Positional anomalies of the right half of the colon are quite common whereas positional anomalies of the left half of the colon are much less common because of embryological disorders during the period of the embryological development of that part of the bowel. The process of the fixation of the descending colon to the posterior abdominal wall can be absent. In that case, when the descending colon has a free descending mesocolon, it shows some degree of mobility.
We are presenting an example of one of the anomalies, which is characterized by the persistent descending mesocolon, which extends from the splenic flexure or just below it to the sigmoid colon. The persistent descending mesocolon in our case contains or surrounds almost complete small bowel in a recess which is located laterally to the left of the midline. The content of this hernial sac simulates the symptoms of an internal hernia followed by clinical symptoms and roendgenographical signs.
We are of the opinion that this anomaly is more common than some surveys of literature would suggest.
结肠右半部分的位置异常相当常见,而结肠左半部分的位置异常则因该部分肠道胚胎发育期间的胚胎学紊乱而少见得多。降结肠与后腹壁的固定过程可能缺失。在这种情况下,当降结肠有一个游离的降结肠系膜时,它会表现出一定程度的活动度。
我们呈现其中一种异常情况的示例,其特征为降结肠系膜持续存在,从脾曲或其下方延伸至乙状结肠。我们病例中的持续性降结肠系膜在位于中线左侧的一个隐窝中包含或环绕几乎整个小肠。这个疝囊的内容物引发内疝症状,随后出现临床症状和影像学征象。
我们认为这种异常情况比一些文献调查所显示的更为常见。