Published online May 14, 2014. doi: 10.3748/wjg.v20.i18.5557
Revised: November 10, 2013
Accepted: February 26, 2014
Published online: May 14, 2014
Persistent ascending or descending mesocolon is an embryological anomaly that occurs during the final process of intestinal development in organogenesis. Specifically, the primitive dorsal mesocolon fails to fuse with the parietal peritoneum in the fifth month of gestation. Herein, we describe a case of ascending colon cancer with persistent ascending and descending mesocolon treated by laparoscopic right hemicolectomy. Preoperative computed tomography imaging of the abdomen demonstrated that the descending colon shifted at the midline of the abdomen and the sigmoid colon was located under the ascending colon. The detailed preoperative imaging examination revealed malpositioning of the large intestine and aided in the procedural planning. Because persistent mesocolon may result in the formation of abnormal adhesions, an accurate preoperative diagnosis is essential. We propose that it is important to consider this anomaly when making the preoperative imaging diagnosis to ensure a safe operation.
Core tip: Persistent descending or ascending mesocolon develops as a result of failure of the primitive dorsal mesocolon to fuse with the parietal peritoneum in the fifth month of gestation. In this paper, we report a case in which both ascending and descending mesocolon coexisted. The preoperative computed tomography imaging examination indicated that the descending colon was shifted to the midline, resulting in the sigmoid colon located in the right abdominal cavity and the ascending colon located on the sigmoid colon with a mobile cecum. Prediagnosis of this embryological anomaly could enhance safety of the laparoscopic colon surgery.