A CASE OF SIGMOID MEGACOLON DUE TO CHRONIC INTERMITTENT SIGMOID VOLVULUS SECONDARY TO MESENTERIUM COMMUNE WITH NON-FLXATION OF THE DESCENDING COLON

Abstract

We report a case of sigmoid megacolon due to mesenterium commune with non-fixation of the descending colon. A 24-year-old woman was seen at the hospital because of abdominal pain and abdominal fullness. Barium enema showed that the dilated and elongated sigmoid colon was slightly twisted by the movement of the descending colon with changes in body position. The patient was diagnosed as having a sigmoid megacolon caused by chronic intermittent volvulus of the sigmoid colon and was operated on. At laparotomy, the sigmoid colon dilated and elongated, and the ascending colon only partly fixed to the retroperitoneum. The descending colon completely unfixed to the retroperitoneum, so the left hemicolon could be lifted out of the abdomen. Resection of the dilated sigmoid colon was performed with end-to-end anastomosis. Histopathological examination revealed that the ganglion cells of the sigmoid colon were normal, as were the mucous membrane, submucosa, and muscle layer. Sigmoid megacolon or volvulus of the sigmoid colon due to mesenterium commune with non-fixation of the descending colon occurs rarely and this is the fourth report in the Japanese literature.