WOFAPS 2025 8th World Congress of Pediatric Surgery

Sevgi Ulusoy Tangül ¹, Atilla Şenaylı ¹, Rezzan Sayar ², Kübra Taşdan ²

¹ Kırklareli University, School of Medicine, Department of Pediatric Surgery
² Bozok University,Health Practice and Research Hospital

Purpose:
Dolichocolon, or dolicosigmoid, is an anatomical variant involving elongation and redundancy of the distal colon. Though often asymptomatic, it can cause chronic constipation, abdominal pain, bloating, encopresis, and rarely hemorrhoids, significantly affecting children’s quality of life. Misdiagnosis may lead to unnecessary interventions. Diagnosis is primarily based on contrast-enhanced distal colon radiography, with findings such as redundant loops and right-sided elongation of the sigmoid colon. This study presents our institution’s clinical experience with pediatric dolichocolon cases to inform optimal management strategies.

Methods:
Between January 2022 and July 2024, 42 children presenting with gastrointestinal symptoms underwent distal colonography and were diagnosed with dolichocolon. Patients were assessed for dietary relevance and chronic constipation-related symptoms.

Results:
Of the 42 patients, 23 were male and 19 female, with a median age of 7.5 years (4 months to 17 years). The most common symptoms were constipation and abdominal pain (52.3%), followed by encopresis (11.9%). All patients received dietary guidance, medical treatment, and toilet training. Symptom resolution was achieved with family-centered conservative approaches. Notably, infants under one year showed rapid improvement, likely due to higher colonic plasticity. Only one patient—an adolescent with refractory symptoms—underwent partial sigmoid resection, resulting in marked postoperative improvement.

Conclusions:
While dolichocolon is common, it remains underrecognized in pediatric colorectal complaints. Early imaging following basic laboratory evaluation is essential. Infants respond well to conservative measures, underscoring the importance of age-tailored treatment. The study's limitations include its retrospective nature and limited sample size.