The colon has four segments: the caecum wherein the appendix is attached; ascending, transverse and descending colon
; sigmoid; rectum or anus.
Patients with colon cancer at the descending colon
or above the descending colon
On endoscopic examination of the colon, a pedunculated mass partially obliterating the lumen of the descending colon
was detected (Figure 2).
Colonoscopy revealed non-specific colitis but no organism was found on histopathology of multiple biopsies taken from caecum, ascending, transverse and descending colon
. However, duodenal biopsy revealed moderate stunting of villi, severely increased intraepithelial lymphocytes and few Strongyloidesstercoralis adult forms in the lining epithelium (Figure).
Total number of variations is 1 out of 30 adult, sigmoid colon is attached 3 cm above the descending colon
in adult female specimen.
The total abdominal augmentation computed tomography and total colorectal sputum angiography showed that the upper and middle rectum, descending colon
, transverse colon, and ascending colon were dilated, the maximum diameter of the intestine was 23 cm, and the intestine was filled with feces, suggesting that the lower rectum and sigmoid colon were narrow [Figure 1]a and [Figure 1]b.
"I have done a colonoscopy which shows polyps in the descending colon
Therefore, recurrent partial obstruction with the leading point at the cecum may cause an intussusception from the distal ileal segments down to almost descending colon
. In literature, there has been very limited number of cases with ileo-rectal or ileo-anal intusus-susception (See comment in PubMed Commons below13-16).
Cecal volvulus is a folding of the terminal ileum and descending colon
with its mesentery on its own axis.
[2-4,7,9] CT may variably show a whirl sign (twisted intestine and mesentery), along with medial deviation of the caecum with a beak appearance of the descending colon
, or a dilated loop of sigmoid colon with convergence of the superior mesenteric vessels toward the knot.
Eleven (21%) patients had tumors located in the cecum, ten (19%) had tumors located in the ascending colon, three (6%) had tumors located in the hepatic flexure, nine (17%) had tumors located in the transverse colon, three (6%) had tumors located at the splenic flexure, three (6%) had tumors located in the descending colon
, and fourteen (26%) had tumors located in the sigmoid colon.
Figure 4(c) shows the distribution of accurate classification for individual colon parts which rates from 67.7% in descending colon
to 93.3% in hepatic flexure.