As previous reports had showed that associated colonic diverticulosis is frequently found in the patients with small bowel diverticulosis [12, 13], the present patient also developed coexistent diverticula in the ascending colon
. The present patient was not elderly, but most patients were in the sixth and seventh decade of life in the previous reports [14-17].
There were also multiple raised ulcerated lesions in the ascending colon
Site Falterman et al Present study Caecum 10.42 10.52 Ascending colon
4.78 9.58 Hepatic flexure 3.60 0.93 Transverse colon 5.15 5.26 Splenic flexure 3.85 1.5 Descending colon 5.11 2.81 Rectosigmoid colon 67.09 69.4 Total 100 100 The above table shows that in the present study the distribution of cancer throughout the colon was correlating with the study conducted by Falterman et al which states recto sigmoid colon as a commonest site of colorectal malignancy.
The presentation reported here is unusual in that there was encasement of the terminal ileum within a sac, and this itself, along with rest of the small bowel, stomach and ascending colon
was encased within a larger sac.
Intussusception with terminal ileum (gangrenous), caecum, appendix, whole of ascending colon
, transverse colon were telescoping into descending and sigmoid colon.
During this time, it continues to rotate a further 180 [degrees] counterclockwise, bringing the ascending colon
to the right side of the abdomen with the caecum lying immediately below the liver.
* Ascending colon
perforation is quite rare in blunt trauma as it is fixed to retroperitoneum.
She was referred to the Radiology Department for CT scan which revealed a well-defined oval shaped lesion, measuring 7.2 x4.5 cm, containing air lucencies in the right mid abdomen abutting the ascending colon
, small bowel loops and the left anterolateral abdominal wall (Figure-1, A and B).
In the present study, we noted that almost one third of colon cancer involved the right side of the colon, including caecum, ascending colon
, hepatic flexure and the right one third of transverse colon.
Per-operatively, left-sided acutely inflammed appendix along with caecum and ascending colon
were found in left lower abdomen, operation was completed via lower midline abdominal incision.
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.