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Location of the transverse colon in relationship to the umbilicus: implications for laparoscopic techniques
S S Chee1, C D Godfrey, J A Hurteau
1Department of Radiology, Indiana University School of Medicine, Indianapolis, USA.
Study Objective:
To establish the location of the transverse colon in relationship to the umbilicus, and determine if it varies as a function of patient height or weight.
Design:
Retrospective review of computed tomograms (CT) of the abdomen (Canadian Task Force classification II-2).
Setting:
University hospital.
Patients:
Sixty-seven women with normal abdominal anatomy.
Intervention:
Review of abdominal CT scans.
Measurements And Main Results:
The relative relationships of the transverse colon and umbilicus were compared with age, height, weight, and body mass index (BMI = kg/m2) using multiple regression analysis. Average location of the superior margin of the transverse colon was 4.6 cm (95% CI 3.5-5.7 cm) above the umbilicus. In nine (13%) women it was below the umbilicus. The colon was below the umbilicus in 25% of nonobese women (BMI <25 kg/m2).
Conclusion:
Because the transverse colon lies below the umbilicus in more than 10% of women, injury to it may be an uncommon yet unavoidable complication of laparoscopy.