Laparoscopic right hemicolectomy for ascending colon cancer with persistent mesocolon

Abstract

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.

Laparoscopic high anterior resection for triple colorectal cancers with persistent ascending and descending mesocolons: A case report

“…To the best of our knowledge, only three case reports have described the coexistence of persistent ascending and descending mesocolons (4,5,7). To the best of our knowledge, only three case reports have described the coexistence of persistent ascending and descending mesocolons (4,5,7).…”

“…Persistent descending mesocolon is characterized by various lengths of the persistent mesentery, and the descending colon may be shifted to a more medial position than usual. Such failure of fixation has often been demonstrated radiographically (1), and some cases of persistent mesocolon were recently reported in the field of laparoscopic colon cancer surgery (5,6). Although some clinical complications of persistent mesocolon, such as primary intestinal obstruction, colonic volvulus, and intussusception (2)(3)(4), have been reported, this condition is asymptomatic in most cases (1).…”

“…In patients with persistent ascending and descending mesocolons, the sigmoid colon is located under the ascending colon. Characteristic anomalies, including adhesion between the mesentery and pelvic wall and a short descending mesentery, as well as the importance of careful surgical procedures were described (1,5,6). Such failure of fixation has often been demonstrated radiographically (1), and some cases of persistent mesocolon were recently reported in the field of laparoscopic colon cancer surgery (5,6).…”

“…Such failure of fixation has often been demonstrated radiographically (1), and some cases of persistent mesocolon were recently reported in the field of laparoscopic colon cancer surgery (5,6). Characteristic anomalies, including adhesion between the mesentery and pelvic wall and a short descending mesentery, as well as the importance of careful surgical procedures were described (1,5,6).…”

A colovesical fistula with a persistent descending mesocolon due to partial situs inversus: A case report

“…In our case, a CT scan showed the descending colon shifted to the midline of the abdomen with radial branches from the inferior mesenteric artery instead of a marginal vessel. Moreover, intraoperatively, there were adhesions noted at the dorsal aspect of the descending and sigmoid mesocolon–typical of PDM [19]. PDM causing intestinal obstruction is a known clinical complication [20].…”