Unexpected right-sided sigmoid colon in laparoscopy: A case report and review of literature

Abstract

BACKGROUND

The presence of a right-sided sigmoid colon is a rare anatomical variation usually discovered incidentally during surgical interventions. This case report details an unexpected right-sided sigmoid colon identified during a laparoscopic appendectomy and examines the pertinent literature to explore its clinical importance.

CASE SUMMARY

A 71-year-old woman presented with acute appendicitis. A preoperative computed tomography (CT) scan showed peri-appendiceal inflammation but no significant anatomical abnormalities. During laparoscopic surgery, an unexpected finding was encountered: The sigmoid colon was situated on the right side and exhibited an abnormal relationship with the cecum and ascending colon. Postoperative pathological examination confirmed appendicitis with no additional pathological findings. The right-sided sigmoid colon anomaly was verified through intraoperative assessment and later re-evaluation with CT and colonographic imaging. The patient underwent a laparoscopic appendectomy and experienced a smooth postoperative recovery.

CONCLUSION

This case highlights the necessity of being attentive to anatomical variations during laparoscopic surgery, particularly when managing appendicitis. A review of the literature indicated that the occurrence of a right-sided sigmoid colon is infrequent and may be associated with anomalies in midgut rotation during embryonic development. Awareness of this variation can help prevent surgical complications and inform future clinical practice.

Keywords: Right-sided sigmoid colon; Laparoscopy; Anatomical variation; Literature review; Surgical implications; Case report

Core Tip: This case report spotlights an unexpected right-sided sigmoid colon detected during laparoscopic appendectomy, emphasizing its clinical impact. Surgeons must be vigilant for such anatomical variations in minimally invasive surgery. A literature review reveals the rarity and embryological roots of this condition, crucial for preventing surgical errors. The case highlights the necessity of preoperative imaging and intraoperative assessment for detecting and managing this anatomical peculiarity.