-requires manual facilitation. Last updated November 16, 2023. noun. OBJECTIVE. ileocecal valve. However, it has been reported as of a rapidly fungating type, following mucous colitis ulcers. The aim of this work is to describe the feasibility of performing laparoscopic D3 resection in SFC and its impact on long-term survival. S1). 94 to 4. Purpose: The treatment of splenic flexural colon cancer is not standardized because the lymphatic drainage is variable. The larger the aneurysm, the more dangerous it can be. 45 cm long. In the meantime I am somewhat nervous about what this all means. Cancer of the splenic flexure is defined as colon cancer situated between the distal third of the transverse colon. True. The splenic flexure, also known as the left colic flexure, is the sharp bend between the transverse and descending parts of the colon. Citation, DOI, disclosures and article data. Purpose: Minimally invasive resection of colon cancer at the splenic flexure can be technically challenging with concerns for a suboptimal oncologic outcome. The left colic or splenic flexure is situated at the junction of the transverse and descending parts of the colon, and is in relation with the lower end of the spleen and the tail of the pancreas; the flexure is so acute that the end of the transverse colon usually lies in contact with the front of the descending colon. The spleen is a highly vascular organ that participates in hematologic and immune homeostasis. Splenic hilar LNs dissection: The first step is dissection of the LNs in the inferior pole region of the spleen. A 50 year-old male with a body mass index of 45 has uncontrolled diabetes and hypertension. It is held on to the diaphragm by a peritoneal fold, the phrenicocolic ligament on which the spleen sits. The cases consisted of 18 men and 13 Women, ranging in age from 33 to 84 years (mean, 62. 88%), between the hilum and lower pole of the spleen in 12 (8. splenic disease: Milzkrankheit {f} med. The case report describes the rare presentation of a 79-year-old patient with a locally perforated splenic flexure tumour of the colon presenting with an apparent empyema thoracis in the absence of abdominal signs or symptoms. A standard surgical approach to these cancers has not been defined. It turns downwards as the descending colon, which, like the ascending colon, is retroperitoneal. The rate of stage III disease and the number of patients treated by adjuvant chemotherapy were similar between the 3 groups. Large intestine in a cadaver: The splenic flexure of the large intestine is a 'watershed area' in terms of blood supply. Subtotal colectomy was more often performed by laparotomy compared with splenic flexure colectomy and left hemicolectomy (93% vs 61% vs 56%, p < 0. 7%) or extended procedures (extended right and left colectomies; n = 513, 39. , Jr Clinical experiences with the splenic flexure syndrome and the hepatic flexure syndrome. Patient Positioning for Laparoscopic Splenic Flexure. Splenic flexure mobilization is an integral component of sigmoid, left colon, and rectal resections, and is required for total abdominal colectomy. Study with Quizlet and memorize flashcards containing terms like Retroperitoneal organs have a serosa facing the peritoneal cavity and a(n) ________ on the posterior side embedded in the abdominal wall. 1 In this case, the attacks began after she started to work mainly in a standing. Mucosal ulcer in stomach or duodenum >5mm, covered w/ fibrin, extending through the muscularis mucosa; H. 8%. Uncommonly encountered entities of the spleen include focal. A 14-year-old boy with no medical history had severe left upper. 2) Mobilization of the splenic flexure . This retrospective study was performed to determine the amount of colonic redundancy that can be expected by SFM. Most splenic lesions are detected incidentally, posing a challenge for both interpreting and referring physicians in determining the need for and type of further evaluation. The descending colon lies on the posterior abdominal. Splenomegaly in children – (See "Approach to the child with an enlarged. D) Patient was rotated toward the left side. Given the fact that, less than 100 cases have been reported in the literature, this diagnosis is rarely. The splenic flexure lies in the upper left quadrant between the transverse and descending colon. splenic flexure [Flexura coli sinistra, Flexura splenica] linke Dickdarmflexur {f} med. The splenic flexure was above the hilum of the spleen in 95 patients (67. Although splenic flexure mobilization occasionally looks complicated, it consists of five simple procedures: 1, division of the line of Toldt (dividing the lateral peritoneal attachment); 2, division of the gastrocolic ligament (dividing the greater omentum and transverse colon, then entering the lesser sac); 3, division of the. It lies more cranial than the right colic. called also left colic flexure. The 2024 edition of ICD-10-CM D12. 결장의 비굴곡부는 좌상복부의 비장 전방에 위치하며 횡행결장과 하행결장 사이에서 예각을 이루고 있다. 3%). We reviewed the patterns of vascular anatomy and the definition of the vessels around the splenic flexure. The high anatomical position of the splenic curvature causes an acute. Dr Mark Percy. Most anatomy texts describe the location as two-thirds along the transverse colon. 8,9 Only few studies with small sample sizes have demonstrated better short-term outcomes and similar long-term outcomes of left hemicolectomy performed laparoscopically than open. , tumors located between the distal third of the transverse colon and the first part of the descending colon, account for. The splenic flexure, the highest-reaching segment of the colon, may become distended as the gas rises to fill it. This is because of various factors, namely that the splenic flexure tends to be high up in the abdomen. Splenic flexure. The splenic flexure is both higher and further from the midline in men than in women. Mobilization of the splenic flexure remains one the most challenging steps of any colorectal operation (Mackenzie et al. Pediatric trauma patients present unique clinical challenges as compared to adults, including different mechanisms of injury, physiologic responses, and indications for operative. noun. 10–12stomach spleen l. splenic disease: Milzerkrankung {f} med. Copy. Diagnosis Diarrhea: painless loose or watery stools for at least 75% of stools. When resection of the distal transverse colon is performed, surgeons must be aware of the blood supply to the splenic flexure colon. Medial to the spleen is the left kidney; superior is the diaphragm, while inferiorly it rests directly on the left colic flexure (splenic flexure). Keywords: Spleen, Colon, Splenic flexure. ectopically located or malpositioned spleen. Splenomegaly is one of the characteristic signs of an overactive spleen. What is the most likely cause of this problem? A) Anatomical variation. Such drainage preserves the spleen and avoids the. colic flexure. cervical flexure a bend in the neural tube of the embryo at the junction of the brain and spinal cord. 0b013e3182687f10 Corpus ID: 11685326; Is Splenic Flexure Mobilization Necessary in Laparoscopic Anterior Resection? @article{Chand2012IsSF, title={Is Splenic Flexure Mobilization Necessary in Laparoscopic Anterior Resection?}, author={Manish Chand and Danilo Miskovic and Amjad Parvaiz},. Splenic flexure cancer was defined as a tumor located in the distal third of the transverse colon, or in the left colonic angle, or in the proximal descending colon within 10 cm from the flexure []. splenic flexure [Flexura coli sinistra, Flexura splenica] linke Dickdarmflexur {f} med. It has multiple aetiological factors with some encountered much more frequently than others. We present the case of a woman in her 50s presenting with acute abdominal pain and absolute constipation. If the colon does not reach the anterior abdominal wall in a tension free manner for colostomy creation, splenic flexure mobilization may be necessary. The splenic flexure was above the hilum of the spleen in 95 patients (67. The surgeon uses an ultrasonic scalpel to separate the greater omentum toward the left up to the splenic flexure of the colon along the superior border of the transverse colon. Important technical aspects of a complete splenic flexure mobilization (SFM) are described, such as selective indication, the best moment to perform, the need for additional ports and technical aspects, to discuss indications and outcomes. From October 2005 to May 2014 minimally invasive approach was proposed to all patients with histological diagnosis of splenic flexure. 5% of body weight. MAIN OUTCOME MEASURES: We evaluated Clavien-Dindo ≥3 postoperative complications and oncological (number of lymph nodes removed, length of free proximal and distal margins. e. . Scroll through these images from a patient who presented with abdominal pain, and bloody, diarrhoea. Splenic Flexure. Splenic flexure (SF) carcinoma is relatively uncommon, representing only 3% to 5% of all colon cancers. 5 cm thick, 7. Crohn's disease, colon cancer, or any disease that causes intestinal obstruction, may also cause abdominal bloating. Techniques for colon resection are reviewed. Conclusion Preoperative evaluation of the venous pattern of the splenic flexure on 3‐D CT is useful before complete mesocolic excision with central vascular ligation. A ruptured spleen is typically caused by a blow to the left upper stomach or the left lower chest, such as might happen during sporting accidents, fistfights and car crashes. 6 per cent. DOI: 10. 1%); type 3,. The reported success rate of percutaneous drainage ranges from 67% to 100%. Blood in your stool may be bright or dark red. 57%), at. The preference for segmental resection of the splenic flexure is relatively low in several centers , while others strongly advocate for this colon-sparing option as it avoids unnecessary resection of the middle colic vessels and preserves colonic length [6–10]. There have also been few studies on the safety and feasibility of laparoscopic surgery for SFCC. Postoperative adhesions is a predisposing factor for splenic injury, and management is either. 02; 95% CI 1. A healthy. 17. Early imaging with MRI in the case of pregnancy is indicated and early surgical intervention once the diagnosis is established. 5 years (range 48–85); the male:female ratio was 9:14. American Heritage® Dictionary of the English Language, Fifth Edition. How to say splenic flexure in English? Pronunciation of splenic flexure with 3 audio pronunciations, 1 meaning, 13 translations and more for splenic flexure. stomach. Objective: This study aimed to compare splenic flexure colectomy, left hemicolectomy, and subtotal colectomy for perioperative, histological, and survival outcomes in this setting. A splenic flexure volvulus (SFV) is usually densely attached to its adjacent organs, making it the least common site to develop a colonic volvulus [ 2 ]. 6. 3%) underwent extended left. Splenic flexure volvulus (SFV) is a very rare condition that is unlikely to be suspected even when a patient has repeated episodes of abdominal pain and dyschezia. Colon cancer is a common disease process in the USA with an estimated yearly incidence of nearly 100,000 patients []. Wörterbuch Englisch → Deutsch: splenic flexure: Übersetzung 1 - 41 von 41: Englisch: Deutsch: anat. Practice Essentials. Deepen the dissection in the subcutaneous tissues with electrocautery until the anterior rectus fascia. The liver is the second largest organ weighing around 1500 g, which accounts for 2. As such, the differential diagnosis and subsequent management are based primarily on imaging characteristics. Background The effectiveness of surgical treatment for splenic flexure carcinomas (SFCs) in emergency settings remains unexplored. 1). 5. It is held on to the diaphragm by a peritoneal fold, the phrenicocolic ligament on which the spleen sits. 1,2 This syndrome The splenic flexure is a part of the large intestine that consists of a bend near an organ called the spleen. Injury to the left side of the body. 25; p < 0. 6 % of all splenic flexure resections. 9 g/dL, and a hematocrit of 35. flexure: Biegung {f} spec. 2. B) Patient was rotated toward the right side. Your splenic flexure is in the sharp. Splenic abscess is a rare entity, with a reported frequency of 0. sharp abdominal spasms or cramping. Scott Freathy, MD, CPCSplenomegaly is defined as enlargement of the spleen, measured by size or weight. Posterior and medial the descending colon is retroperitoneal. It may be induced experimentally by the introduction and. From: xPharm: The Comprehensive Pharmacology Reference,. The descending colon is covered by peritoneum on its anterior and lateral surfaces. Splenic infarction refers to occlusion of the splenic vascular supply, leading to parenchymal ischemia and subsequent tissue necrosis. Laparoscopic splenic flexure mobilization (LSFM) is a common step of total abdominal colectomy or resection of a distal transverse or left-sided lesion. Materials and Methods: We performed a retrospective review of 51 operative notes for complete SFMs performed at a single institution from January 2015 to June. Of the locations that colon cancer can develop, splenic flexure cancer (SFC), defined by most studies as cancer located in the distal third of the transverse colon to proximal 10 cm of the descending colon, is a rare entity. Design: A 3-round online-based Delphi study was conducted between September 2020 and April 2021. PROCEDURE. splen·icA splenic flexure volvulus (SFV) is usually densely attached to its adjacent organs, making it the least common site to develop a colonic volvulus [ 2 ]. I have suffered from splenic flexure syndrome for 35 years. The general issues surrounding resecting the colon are reviewed here. 3 became effective on October 1, 2023. SFV can be categorized into both primary and secondary etiologies. Medical history, physical examination, X-ray can be help in. Splenic complications after. An injured spleen can rupture soon after the stomach trauma or, in some cases, days or weeks after the injury. splenic. | Alle Sprachen The splenic flexure is a part of your colon, or your large intestine, where it bends near your spleen, an organ that mainly filters your blood. Hajivassiliou and G B Farrow and Joanne Harvey},. When this area becomes irritated or inflamed, it can lead to a variety of symptoms that can affect a person’s daily life. 3 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. Study with Quizlet and memorize flashcards containing terms like What is the function division of the GI tract based on?, What is the foregut supplied by and from. Overview. Sigmoidoscopy. A curve, turn, or fold, such as a bend in a tubular organ: a flexure of the colon. It turns downwards as the descending colon, which, like the ascending colon, is retroperitoneal. Benign neoplasm of hepatic flexure. position. constipation. Carcinoma of the splenic angle is consistently one of the rarest of colon carcinomata, that of the descending colon alone being more rare. Objective: This study aimed to establish an expert international consensus on splenic flexure carcinoma management. After detaching the colon from the parietal peritoneum, we changed the patient's position into a reverse Trendelenburg position, detached the omentum from the transverse colon starting at the level of the falciform ligament and extending to the splenic flexure colon, and then entered the lesser sac. The neonatal small left colon syndrome (NSLCS) is an uncommon condition characterized by an abrupt intestinal caliber transition at or near the splenic flexure and colonic obstruction. Methods: From July 2013 to January 2016, consecutive patients of the splenic flexural colon cancer with a preoperative diagnosis of N0 who underwent. Comparison of the clinicopathological characteristics and survival for the patients with splenic flexure, right-sided colon and SD & S colon cancer. Introduction. d. descending colon becomes the sigmoid colon, Which of the following is an extension of the peritoneum? a. Study with Quizlet and memorize flashcards containing terms like A 2-year-old male patient presents with intermittent RLQ pain, vomiting, palpable abdominal mass, and red currant jelly stool. Splenic flexure syndrome is a chronic disorder producing symptoms of pain that are caused by trapped gas in the bends of the colon or splenic flexure. Posture advice, including the knee–chest position and abdominal compression using colonic intraluminal pressure for the resolution of incomplete volvulus during pain attacks, was effective. 2. Splenic lesions are commonly encountered and are often incidental in nature. Optimal treatment of splenic flexure (SF) colon cancer—less than 10 % of all colorectal cancers is a matter of debate, in particular with regard to the optimal extent of radical surgery, according to the oncological principles of curative resection. INTRODUCTION. Splenic flexure takedown is an important surgical step during the resection and reconstruction of left-sided colonic and rectal cancer [1, 2]. Laparoscopic approach to splenic flexure and transverse colon cancer, however, is still a matter of debate and considered challenging for both anatomical and technical aspects. What is a splenic flexure takedown? Introduction: Take down of the splenic flexure is a crucial part of laparoscopic anterior resection . dict. B) Patient was rotated toward the right side. pylori infection present 90% of peptic ulcers; Epigastric, may radiate straight to the back; Variable-epigastric gnawing or burning (dyspepsia), may also be boring, aching, or hungerlike-No symptoms in up to 20%. 2. However, the diagnosis of certain focal lesions of the spleen can be difficult, even with modern imaging, sometimes requiring a histologic tissue examination obtained by percutaneous biopsy or even by surgery to obtain a definite diagnosis [3], [4]. 11:56. Left colic flexure (or splenic flexure) is the bend in the large intestine in the left upper quadrant of the abdomen as the transverse colon continues as the descending colon. Methods. e. Splenic flexure volvulus. The splenic hilum contains nerves, splenic vessels, and also contains attachments for the splenorenal and. splenic flexure. The act or an instance of bending or flexing; flexion. cephalic flexure the curve in the mid-brain of the embryo. [ PMC free article] [ PubMed] [ Google Scholar] PALMER ED, DEUTSCH DL, SCOTT NM. Finally, the lateral attachments of the descending colon at the Toldt’s fascia are dissected to achieve complete take down of the splenic flexure. Übersetzung für 'splenic flexure' von Englisch nach Deutsch splenic flexure [Flexura coli sinistra, Flexura splenica] linke Dickdarmflexur {f}anat. Splenic flexure: This is the sharp bend between the transverse colon and the descending colon. Intraoperative, pathologic and postoperative data from patients undergoing laparoscopic. They are generally thought to have a poorer prognosis as they are often discovered at a more advanced stage and have an increased risk of bowel obstruction [1, 3]. This represents an important. A) splenic flexure B) cecum C) hepatic flexure D) ileocecal valve E) haustra and more. Much has been written about the myriad pathologic conditions that can occur in the spleen; however,. Although uncommon in the general population, ischemic colitis occurs with greater frequency in the elderly, and is the most common form of bowel ischemia. Figure 2. Use of the dVXi may result in shorter operative time, less estimated blood loss, and faster postoperative recovery than its predecessor, the da. Postoperative period was uneventful with good. Size and weight vary from person to person but on average, the spleen is around 2. The Left Upper Quadrant Contains: Stomach Spleen Left lobe of liver Body of pancreas Left kidney and adrenal gland Splenic flexure of colon Parts of transverse and descending colon. The inferior splenic margin is blunted, descending. descending colon becomes the sigmoid colon, Which of the following is an extension of the peritoneum? a. . 3 - other international versions of ICD-10 D12. The sigmoid colon was. 88%), between the hilum and lower pole of the spleen in 12 (8. Surgery was done for splenic pus drainage. Introduction. Small splenunculi (<1 cm) may appear hypodense compared. Viewing of the interior of the colon, entire large intestine (rectum to ileocecal valve) Colonoscopy. Gas can get trapped within the splenic flexure, causing further pain and discomfort. It lies at a higher level than, and on a plane posterior to, the right. Starling 2 has compared this process with the contractions in the pyloric end of. 1-2 cm. Splenic flexure mobilisation (SFM) is one of the fundamental surgical steps during colorectal procedures. D12. Irregularities of the bowel caused by splenic flexure syndrome (SFS) may manifest as diarrhea or as constipation. 2 • (A) Splenomegaly in portal hypertension. So far, less than 80 cases have been reported worldwide since 1970. 7%. Fifty-four cases of splenic rupture after colonoscopy have been described in the literature. The preservation of functional splenic tissue is secondary and in selected patients can be accomplished using nonoperative management or operative salvage techniques. The most likely mechanism for this complication is tension on the splenocolic ligament, or from pre-existing adhesions, or both, due to manipulations of the sigmoid, descending colon, or transverse colon, or resulting passage of the endoscope through the splenic flexure resulting in parenchymal tears or avulsion of the spleen [6, 7]. 4 to 8 percent of colonic procedures . Purpose The treatment of splenic flexural colon cancer is not standardized because the lymphatic drainage is variable. reticuloendothelial. Activity restriction may be suggested for 4–6 weeks in minor injuries and up to 2–4 months in moderate and severe injuries (GoR 2C). The factors associated with splenic injury include difficulty intubating, looping of the instrument, traction on the splenocolic ligament, adhesions between the colon and spleen, and presence of a large polyp or mass at the splenic flexure. 4%) subjects at the splenic flexure and sigmoid colon, respectively. Spleen Injury – The spleen becomes swollen and irritated due to blunt force trauma and other types of physical injury. As the latter invades through the spleen matter, there is the creation of a splenocolic fistula, which allows the migration of normal gut flora into the spleen. The diagnosis and prompt management of potentially life-threatening hemorrhage is the primary goal. . Presently, it is acknowledged that laparoscopic colectomy for left sided. 11:56. Methods: The surgical outcomes and relevant anatomic structures of 104 consecutive patients undergoing. A left hemicolectomy is used to remove tumours in the transverse colon, splenic flexure (the bend in the colon near the spleen) and the descending colon. Patients usually present with recurrent episodes of intestinal. 2A) and it may extend below the left kidney and into the pelvis. 9. The splenic flexure is situated next to the spleen and a section of the large intestine or colon. . 9–33. Splenic flexure mobilization, whether it be open or laparoscopic, is the most demanding part of laparoscopic colorectal surgery with complex technical details. Abdominal pain, which can be severe, last for several minutes, and. True/False. The factors associated with splenic injury include difficulty intubating, looping of the instrument, traction on the splenocolic ligament, adhesions between the colon and spleen, and presence of a large polyp or mass at the splenic flexure. d. My doctor said I had IBS and made no mention of IBD. It allows a tension-free anastomosis and a proper exteriorisation of the specimen with the ligated origins of the inferior mesenteric vessels through a minilaparotomy located in the lower abdomen. B) splenic flexure. - Middle 1/3rd: striated and smooth muscles. 3 may differ. In our experience, resections of splenic flexure cancer were performed in 48 cases only, which accounted for 3. LEFM is usually performed to gain length to ensure a tension-free pelvic anastomosis [ 1 ]. 0%). 0001). Tail of pancreasex. RESULTS: The most performed surgery was splenic flexure colectomy (59%), followed by subtotal colectomy (23%) and left hemicolectomy (18%). During the procedure, the gastroenterologist counted the number of diverticula in each segment of the colon (cecum, ascending, hepatic flexure, transverse, splenic flexure, descending, and sigmoid colon) and reported the findings to a research. Examination at that time had shown no other cause for the anaemia. The feeder pattern of the splenic flexure. Background There is ongoing debate regarding surgical treatment of splenic flexure cancer. The splenic flexure marks an intermediate position in the colon both anatomically and physiologically. Background and Objectives: Splenic flexure mobilization (SFM) is performed to ensure a tension free anastomosis with an adequate resection margin in laparoscopic anterior resection (AR) or low anterior resection (LAR). Planning colon resection needs to take into account the nature of the lesion and its location within the colon. bending: deforming force, which imposes tension on the outer curve and compression on the inner curve of a cylindrical bodyA total of 1304 patients were submitted to resection of the splenic flexure (n = 791, 60. In our case, the mother kept repeating: ‘it is the toothpick!’ Most patients consult for an abdominal pain, usually non-specific and often misleading [2, 3Ligament between the spleen and the splenic flexure of the colon. The spleen is very vascular and reddish purple in color; its size and weight vary. 8%) who underwent laparoscopic curative resection for pathologically proven primary. Performing the flexure release as the initial step of the operation can minimize incision length if conversion were needed later. The splenic flexure lies at a higher level compared with the hepatic flexure (Fig. CT A/P PO and IV contrast showed diffuse colonic wall thickening greatest at splenic flexure, descending, and recto-sigmoid colon with associated para-aortic and mesenteric adenopathy. It is characterised by excessive pain, abdominal spasms, bloating, change in bowel movement etc. Splenic flexure volvulus is a rare occurrence in pregnant patients, however this case demonstrates that it should be considered in the differential diagnosis for a patient presenting with acute abdominal pain. The aim of this muticenter study was to report and compare the different surgical procedures. - inferior 1/3rd: smooth muscles. An 85-year-old woman with a remote history of peptic ulcer disease and no history of abdominal surgery presented with rectal bleeding, a hemoglobin of 11. Nakagoe et al. This is the point where the colon makes a sharp bend near the spleen. Study with Quizlet and memorize flashcards containing terms like A blockage in the colon where the ascending colon turns to become the transverse colon would occur at the Select one: a. Splenic infarction may be the result of arterial or venous occlusion. The surgical approach has yet to be standardized. transverse colon is hanging from the anterior aspect of the pancreas and the 2nd part of duodenum by? transverse mesocolon. Abdominal X-ray showed a massive colonic gas niveau (Fig. located in the left upper quadrant or left hypochondrium. UpToDate, electronic clinical resource tool for physicians and patients that provides information on Adult Primary Care and Internal Medicine, Allergy and Immunology, Cardiovascular Medicine, Emergency Medicine, Endocrinology and Diabetes, Family Medicine, Gastroenterology and Hepatology, Hematology, Infectious Diseases. @article{Hajivassiliou1999SplenicFV, title={Splenic flexure volvulus presenting as proximal small intestinal obstruction. In this study, the morphology of the mesentery during the mobilization of the colonic splenic flexure was continuously. It is roughly the size of an individual’s fist, measuring about 10 cm to 12 cm (about 3. The colonic component of the splenic flexure occurs. 3 may differ. A surgical procedure that creates an opening into the jejunum is defined as a: 43770. The tail of the pancreas leaves an impression between the hilum and colic impression sites. Owing to extensive adhesions and a late stage of cancer. 1D, 6. Splenic flexure cancer. The Right Lower Quadrant Contains: Cecum Appendix Ascending Colon Right ovary and Fallopian tube Right ureter. Mortality rate of the SFV cases is low. SF carcinoma is often associated with worse long-term survival compared to other colorectal cancer locations because their diagnosis is usually established and identified at a more advanced stage, and SF carcinoma is associated with a higher risk of obstruction and lymphatic spread. The middle colic arteries were reported to arise independently without forming a common trunk in 8. This figure depicts mobilizing the splenic flexure, one of the challenging components of a left colectomy. The evaluation of splenomegaly in children and considerations related to elective or traumatic splenectomy are discussed separately. location of the spleen. A: Hepatic flexure B: Splenic flexure C: Sigmoid colon D: Ileocecal valve and more. Its volume is on average between 100 to 300 cm 3,12. ileocecal valve. dates searched were from 1969, date of the first case reported, to October 2015 (Table 1 [ 3 - 31 ]). IMV is located close to the ligament of Treitz and passes below lower border of the pancreas to join the. Gas is a normal and healthy part of the digestion process. The splenic flexure lies at a higher level compared with the hepatic flexure (Fig. SFV was first reported in 1953 by Glazer and Adlersberg et al. 3. Since the 1990s, laparoscopic technique has become a standard approach for several surgical procedures in the field of colorectal surgery. hepatic flexure. Methods This retrospective cohort study involved 51 patients who underwent laparoscopic surgery for colon cancer at Tokushima University Hospital from July 2015 to December. The splenic flexure lies at a higher level compared with the hepatic flexure (Fig. In patients undergoing sigmoidectomy or low anterior resection (LAR), splenic flexure mobilization (SFM) frees the descending and distal transverse colon from their respective attachments such that the descending colon will reach into the pelvis for a tension free anastomosis. Design: This is a multicenter retrospective cohort study. [ 1] The infarct may be segmental, or it may be global, involving the entire organ. Purpose This study examined the short- and long-term outcomes of laparoscopic and open splenic flexure colon cancer (SFCC) surgery. 9,10 Opponents of routine splenic flexure mobilization argue that splenic flexure mobilization is a complex procedure, not a complication free approach, and time consuming.