Right-sided descending colon with necrotizing enterocolitis: a rare case report

Area of Science:

• Gastroenterology
• Pediatric Surgery
• Anatomical Pathology

Background:

• Anatomical variations of the colon are well-documented, predominantly affecting the right side.
• Anomalies of the left colon, especially the descending colon, are infrequently reported in medical literature.

Observation:

• A newborn presented with vomiting and gastroesophageal reflux, with imaging revealing a right-sided descending and sigmoid colon.
• The infant later developed necrotizing enterocolitis (NEC), necessitating surgical intervention after conservative treatment failed.

Findings:

• The descending colon was noted to be fixed to the posterior abdominal wall, extending rightward and crossing the midline.
• The colon showed dilation, thickened walls, mucosal ulceration, and transmural necrosis, with severe involvement of the descending and sigmoid colon.
• Pathology confirmed significant inflammatory cell infiltration.

Implications:

• This case underscores the critical need for surgeons to be aware of potential descending colon positional variations.
• Considering such anatomical anomalies preoperatively is vital for enhancing surgical safety and preventing iatrogenic colonic injury.