PDF(Pubmed)
Abstract：
This case report introduces a rare occurrence of transverse colon volvulus associated with persistent descending mesocolon (PDM), a congenital anomaly characterized by the medial positioning of the descending colon due to a failed fusion with the dorsal abdominal wall. We detail the case of an 18-year-old female, with a medical history of surgically corrected coarctation of the aorta and anal atresia, who presented with recurrent transverse colon volvulus despite having undergone a laparoscopic colopexy three years earlier. Physical examination revealed abdominal distension and metallic colic sounds while imaging studies confirmed the recurrence of the volvulus. Laparoscopic partial resection of the transverse colon was performed, which revealed a medially positioned descending colon due to PDM. Postoperative complications included anastomotic failure, necessitating a second operation. The patient was successfully discharged without further complications after seven days. This case underscores the clinical significance of recognizing PDM, highlighting its potential role in causing transverse colon volvulus and increasing the risk of anastomotic failure. It emphasizes the need for surgeons to remain vigilant regarding this congenital anomaly to mitigate unexpected outcomes such as recurrent volvulus and postoperative complications.
摘要：
该病例报告介绍了罕见的横结肠扭转与持续的降结肠系膜（PDM）相关，一种先天性异常，其特征是由于与背腹壁融合失败而导致降结肠的内侧位置。我们详述了一个18岁女性的案例,有手术矫正的主动脉缩窄和肛门闭锁的病史，尽管三年前接受了腹腔镜结肠固定术，但仍出现复发性横结肠扭转。体格检查显示腹胀和金属绞痛，而影像学检查证实了肠扭转的复发。腹腔镜下横结肠部分切除术，显示由于PDM而位于内侧的降结肠。术后并发症包括吻合口失败，需要第二次手术。7天后，患者成功出院，无进一步并发症。这个案例强调了识别PDM的临床意义，强调其在引起横结肠扭转和增加吻合口失败风险方面的潜在作用。它强调外科医生需要对这种先天性异常保持警惕，以减轻意外结果，例如复发性肠扭转和术后并发症。
