The anatomic variations of colon detected by abdominal multi-detector computed tomography

Abstract

Objectives: The aim of this study was to determine the frequency and clinical importance of anatomic variations of the colon. Materials and methods: Multi-detector computed tomography (MDCT) of the abdomen for various indications was performed in 1300 patients in radiology department between January 2010 and September 2011 were retrospectively analyzed to investigate the anatomic variations of colon. Results: The total number of patients undergoing MDCT scans was 1300, of which 640 were female and 660 male. The mean age of patients was 43.02 years (2-92). The number (%) of colons according to their position were as: 34 (% 2,6) anterior and 14 (% 0,9) posterior hepatodiafragmatic, 40 (% 3) interposition of colon between psoas and right kidney, 3 (% 0,2) interposition of colon between psoas and left kidney, 4 (% 0,3) right retrorenal, 16 (% 1,2) left retrorenal, 2 (%0,2) bilateral, 10 (% 0,8) pancreaticogastric, 5 (% 0,4) retrosplenic and 64 (% 4,9) high caecum. Conclusion: Knowledge of the anatomic variations of colon is important for surgical planning or interventional radiologic procedures. Multi-detector computed tomography allows detailed visualization of these variations.

Keywords

• The anatomic variations of colon, multi-detector computed tomography, abdominal computed tomography

Abdomen çok kesitli bilgisayarlı tomografi ile saptanan kolonun anatomik varyasyonları

Abstract

Giriş: Bu çalışmanın amacı kolonun anatomik varyasyonlarının sıklığını ve klinik önemini belirlemektir. Gereç ve yöntem: Ocak 2010-Eylül 2011 tarihleri arasında, radyoloji bölümünde, farklı nedenlerden dolayı abdomen çok kesitli bilgisayarlı tomografi (ÇKBT) çekilmiş, 1300 hasta retrospektif olarak, kolonun anatomik varyasyonları açısından incelendi. Bulgular: ÇKBT çekilmiş 1300 hastanın, 640\'ı kadın ve 660\'ı erkek idi. Ortalama yaş 43,02 yıl (2-92) idi. Kolon varyasyonlarının sayısı: 34 (% 2,6) anterior, 14 (% 0,9) posterior hepatodiyaframatik, 40 (% 3) sağ böbrek-psoas interpozisyonu, 3 (% 0,2) sol böbrek-psoas interpozisyonu, 4 (% 0,3) sağ retrorenal, 16 (% 1,2) sol retrorenal, 2 (%0,2) bilateral, 10 (% 0,8) pankreatikogastrik, 5 (% 0,4) retosplenik kolon ve 64 (% 4,9) yüksek yerleşimli çekum. Sonuç: Kolonun anatomik varyasyonlarının bilinmesi cerrahi ve girişimsel radyolojik işlemlerde önemlidir. ÇKBT bu varyasyonların ayrıntılı bir şekilde gösterilmesine olanak sağlamaktadır.

Keywords

• Kolonun anatomik varyasyonları, çok kesitli bilgisayarlı tomografi, abdomen bilgisayarlı tomografi

References

1. Moore KL, Dalley AF. Clinically oriented anatomy, 4th edn. Lippin- cott Williams & Wilkins, Philadelphia, 1999 pp 218-288.
2. Bergman RA, Afifi AK, Miyauchi R. http://www.vh.org /Providers/ Textbooks/ AnatomicVariants/ OrganSystem/ Text/LargeIntestine. html
3. Moore KL, Persaud TVN. The developing human (clinically oriented embryology), 6th edn. WB Saunders, Philadelphia, 1998;pp 93-112.
4. Ünal B, Kara S, Aktaş A, Bilgili Y. Kolonun BT’de saptanan anatomik varyasyonları. Tanısal ve Girişimsel Radyoloji 2004;10(4):304-8.
5. Risaliti A, De Anna D, Terrosu G, Uzzau A, Carcoforo P, Bresadola F. Chilaiditi’s syndrome as a surgical and nonsurgical problem. Surg Gynecol Obstet 1993;176(1):55-8.
6. Oldfield AL, Wilbur AC. Retrogastric colon: CT demonstration of anatomic variations. Radiology 1993;186(2):557-61.
7. Sherman JL, Hopper KD, Greene AJ, Johns TT. The retrorenal colon on computed tomography: a normal variant. J Comput Assist To- mogr 1985;9(2):339-41.
8. Prassopoulos PK, Gourtsoyiannis NC, Cavouras D, Pantelidis N. Interposition of colon between the kidney and the posas muscle: A normal anatomic variation studied by CT. Abdom Imaging 1994;19(5):446-8.

9. Gore RM, Ghahremani GG, Joseph AE, Nemcek AA Jr, Marn CS, Vogelzang RL. Acquired malposition of the colon and gallbladder in patients with cirrhosis: CT findings and clinical implications. Radiology 1989;171(3):739-42.
10. Murphy JM, Maibaum A, Alexander G, Dixon AK. Chilaiditi’s syn- drome and obesity. Clin Anat 2000;13(3):181-4.
11. Prassopoulos PK, Raissaki MT, Gourtsoyiannis NC. Hepatodia- phragmatic interposition of the colon in the upright and supine position. J Comput Assist Tomogr 1996;20(1):151-3.
12. Dixon AK. Abdominal fat assessed by computed tomography: Sex difference in distribution. Clin Radiol 1983;34(2):189-91.
13. Hopper KD, Sherman JL, Williams MD, Ghaed N. The variable anteroposterior position of the retroperitoneal colon to the kidneys. Invest Radiol 1987;22(4):298-302.
14. Pinto A, Brunese L, Noviello D, Catalano O. Colonic interposition between kidney and psoas muscle: anatomical variation studied with CT. Radiol Med (Torino) 1997;94(1-2):58-60.
15. Prassopoulos PK, Gourtsoyiannis N, Cavouras D, Pantelidis N. A study of the variation of colonic positioning in the pararenal space as shown by computed tomography. Eur J Radiol 1990;10(1):44-7.