Descending-sigmoid colon flexure – An important but surprisingly ignored landmark

Wozniak S, Pawlus A, Grzelak J, Chobotow S, Paulsen F, Olchowy C, Zaleska-Dorobisz U (2022)

Publication Type: Journal article

Publication year: 2022

Journal

Annals of Anatomy-Anatomischer Anzeiger Elsevier

Book Volume: 239

Article Number: 151821

DOI: 10.1016/j.aanat.2021.151821

Abstract

Background: In invasive examinations of the colon, e.g. colonoscopy, the tortuosity of the colon is a crucial factor for successful completion of the procedure. If adjacent segments of the colon bend at acute angles (under 90°), endoscopy may become difficult and troublesome. Methods: We retrospectively enroled 227 individuals (96 female, 131 male) who underwent abdominopelvic computed tomography examination. For inclusion, subjects were required to have a negative history for colonic disease and abdominopelvic surgery. We measured the angle between the descending colon and the proximal part of the sigmoid (in degrees). In addition, the position of the descending-sigmoid flexure was assessed in relation to the left anterior superior iliac spine, the median plane, and anterior aspect of the 5th lumbar vertebra (in mm). The study protocol was reviewed and approved by the local ethics committee. Results: We visualised the descending-sigmoid flexure in all 227 subjects. In one third of cases, the flexure formed an angle smaller than/or 90°. In females, this landmark (mean ± standard deviation) was located 30.2 ± 8.4 mm from the left anterior superior iliac spine, 88.6 ± 14.2 mm from the median plane, and 115.4 ± 21.4 mm from the anterior aspect of the 5th lumbar vertebra. In males, the dimensions were: 32.1 ± 12.8 mm, 97.6 ± 15.8 mm, and 123.9 ± 22.9 mm, respectively. This landmark distance remained constant from the left anterior superior iliac spine regardless of subject age, height and weight. The other measured distances were related to age, height, weight or BMI. Conclusions: The descending-sigmoid flexure is an important landmark in large intestine morphology situated approximately width of two fingers (3 cm) from the left anterior superior iliac spine and one hand width (9–10 cm) from the median plane. In approximately one third of the subjects, the flexure formed an angle of less than/or 90°, which can cause a problem during colonoscopy.

Authors with CRIS profile

Friedrich Paulsen Lehrstuhl für Funktionelle und Klinische Anatomie

Involved external institutions

Wrocław Medical University / Uniwersytet Medyczny we Wrocławiu PL Poland (PL) Wojewódzki Szpital Specjalistyczny w Legnicy PL Poland (PL)

How to cite

APA:

Wozniak, S., Pawlus, A., Grzelak, J., Chobotow, S., Paulsen, F., Olchowy, C., & Zaleska-Dorobisz, U. (2022). Descending-sigmoid colon flexure – An important but surprisingly ignored landmark. Annals of Anatomy-Anatomischer Anzeiger, 239. https://dx.doi.org/10.1016/j.aanat.2021.151821

MLA:

Wozniak, Slawomir, et al. "Descending-sigmoid colon flexure – An important but surprisingly ignored landmark." Annals of Anatomy-Anatomischer Anzeiger 239 (2022).

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