Mori Yoshihiro, Higuchi Ichiro, Tanigawa Takahiko, Ishikawa Akira, Hosomi Sanae, Urano Naomi, Akiyama Yosuke, Gofuku Junji, Hasuike Yasunori
Dept. of Gastroenterological Surgery, Iseikai Hospital.
Gan To Kagaku Ryoho. 2018 Dec;45(13):1833-1835.
Persistent descending mesocolon(PDM)is caused by absence of fusion of the descending colon to the retroperitoneum. We report a case of laparoscopy-assisted surgery for descending colon cancer in a patient with PDM. An 88-year-oldfemale patient complaining of abdominal pain was diagnosed with bowel obstruction, and referred to our hospital. A computed tomography(CT)scan showed bowel obstruction due to descending colon cancer. After decompression of the colon by insertion of a transanal drainage tube, she underwent laparoscopy-assistedleft hemicolectomy. Intraoperatively it was observed that the descending colon was not fixed to the retroperitoneum, and the patient was diagnosed with persistent descending mesocolon. The accessory middle colic artery and the inferior mesenteric vein branched radially. In patients with PDM, the inferior mesenteric artery often branches radially. However, the various morphologies of branching of the accessory middle colic artery and the inferior mesenteric vein have not been reported. It is not clear whether the radial branching of the accessory middle colic artery and the inferior mesenteric vein is characteristic of patients with PDM. We should however expect radial branching of the accessory middle colic artery and the inferior mesenteric vein in such cases.
持续性降结肠系膜（PDM）是由于降结肠与腹膜后未融合所致。我们报告一例腹腔镜辅助手术治疗PDM患者的降结肠癌病例。一名88岁女性患者因腹痛就诊，被诊断为肠梗阻，随后转诊至我院。计算机断层扫描（CT）显示降结肠癌导致肠梗阻。经肛门插入引流管对结肠进行减压后，她接受了腹腔镜辅助左半结肠切除术。术中观察到降结肠未固定于腹膜后，患者被诊断为持续性降结肠系膜。副中结肠动脉和肠系膜下静脉呈放射状分支。在PDM患者中，肠系膜下动脉常呈放射状分支。然而，副中结肠动脉和肠系膜下静脉分支的各种形态尚未见报道。副中结肠动脉和肠系膜下静脉的放射状分支是否为PDM患者的特征尚不清楚。然而，在这种情况下，我们应预期副中结肠动脉和肠系膜下静脉会呈放射状分支。
