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Sigmoid colon

Synonyms: colon sigmoideum
German: Colon sigmoideum

1 Definition

The sigmoid colon is the part of the colon located in the pelvis.

2 Anatomy

2.1 Overview

The sigmoid colon begins at the transition from the colon descendens at about the upper aperture of the pelvis. From there the sigmoid colon runs ventrally to the os sacrum on the right side of the pelvis, then turns back to the middle line, ultimately ending caudally in the rectum. This course covers an s-shaped loop of about 40 cm length, which gives this part of the intestine its name.

The sigmoid colon is located completely intraperitoneally and is attached via the mesocolon sigmoideum to the posterior abdominal wall. The extent of slacked length of the mesocolon reduces toward both ends, so that the sigmoid colon is overall very movable, yet is fixed at its transition points to the rectum and descending colon.

2.2 Blood supply

The arterial supply of the sigmoid colon is carried out via the arteriae sigmoideae from the arteria mesenterica inferior. Within the mesentery there exist numerous anastomoses to the supply vessels of the adjacent sections of the intestine. They ensure the blood flow to the sigmoid colon at the closure point of the sigmoid arteries.

Venous drainage occurs via the vena mesenterica inferior, which opens via the vena lienalis into the portal circulation.

2.3 Topography

The two external iliac arteries arteriae iliacae externae and the left portion of the sacral plexus plexus sacralis are located dorsally to the sigmoid colon. Small bowel loops are located ventrally to the sigmoid; the small bowel loops separate the sigmoid from the bladder (man) or the uterus (woman).

3 Function

The sigmoid colon serves primarily in the further removal of water and the retention of the stools.

4 Clinical observations

The sigmoid colon is a common site of colon carcinomas. Following a sigmoid resection pasty to liquid stools occur . However, due to the high functional flexibility of the colon, the bowel movements normalise again over the course of time.

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