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Review
. 2018 Feb 27;10(2):6-12.
doi: 10.4240/wjgs.v10.i2.6.

Dolichocolon Revisited: An Inborn Anatomic Variant With Redundancies Causing Constipation and Volvulus

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Free PMC article
Review

Dolichocolon Revisited: An Inborn Anatomic Variant With Redundancies Causing Constipation and Volvulus

Dennis Raahave. World J Gastrointest Surg. .
Free PMC article

Abstract

The objective of this review is to examine whether a redundant colon gives rise to symptoms like constipation and volvulus. In 1820, Monterossi made drawings of colons with displacements and elongation of the colon found during autopsy. In 1912, Kienböeck first visualized a redundant colon using bismuth, and Lardennois and Auborg named the anatomic variant dolichocolon in 1914. The criteria were later: A sigmoid loop rising over the line between the iliac crests, a transverse colon below the same line and extra loops at the flexures. The incidence of dolichocolon is 1.9%-28.5%. Dolichocolon seems to be congenital, as fetuses, newborns, and infants exhibit colonic redundancies. Studies have identified a triade of constipation, abdominal pain, and distension. Colon transit time was recently shown to increase significantly with increased number of redundancies, which increases abdominal pain, bloating and infrequent defecation. The diagnosis of dolichocolon is established by barium enema or CT-colonography. Treatment is conservative, or surgical in case of volvulus or refractory constipation.

Keywords: Colon elongatum; Constipation; Dolichocolon; Functional gastrointestinal disorders; Volvulus.

Conflict of interest statement

Conflict-of-interest statement: The author declares no conflict of interest.

Figures

Figure 1
Figure 1
Handmade drawings of dolichocolon forming tortuosities, loops and kinks. From Monterossi[2], 1820.
Figure 2
Figure 2
Different types of dolichocolon. A-C: Redundancies in the sigmoid; D: Generalized redundancies; E: Low transverse colon. From Caffey[16], 1961.
Figure 3
Figure 3
Barium enema showing a fully developed dolichocolon: A sigmoid loop rising over the line between the iliac crests, a transverse colon below the same line and extra loops at the flexures.
Figure 4
Figure 4
Dolichocolon with loose mesenteries allowing the colon to be drawn out of the abdomen: The transverse colon is localized at the right, and the sigmoid loop at the left.

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