Frequency of right lower quadrant position of the sigmoid colon in infantsand young children

PURPOSE: To evaluate the frequency of right lower quadrant positioning of t he sigmoid colon in infants and young children. MATERIALS AND METHODS: Findings in 169 patients who underwent enema examina tion were retrospectively reviewed. Sigmoid colon position was categorized as in the left or right lower quadrant or midline. Patients who had an anat omic abnormality that affected colonic position (eg, malrotation or abdomin al mass) or had previously undergone abdominal surgery were excluded. The f requency of right lower quadrant sigmoid position was evaluated for a relat ionship with patient age (analysis of variance) and sex (chi (2) test). RESULTS: Patient ages were 7 day to 5 years (mean age, 13 months). The sigm oid colon was in the right lower quadrant in 74 (44%), in the left lower qu adrant in 73 (43%), and in the midline in 18 (11%). The position was variab le in one patient and indeterminate in three. When the sigmoid colon was wi thin the right lower quadrant, it often extended laterally, overlying the p osition of the cecum and ascending colon. There were no significant correla tions between right lower quadrant position and patient age (P = .262) and sex (P = .162). CONCLUSION: In children, the sigmoid colon is often within the right lower quadrant. Knowledge of this high frequency should reduce the likelihood of misinterpreting air within a redundant right-sided sigmoid colon as air wit hin the cecum in children suspected of having abnormalities such as intussu sception.