Dolichocolon causing intestinal obstruction in neonates: a case series

Dolichocolon is a rare congenital colonic redundancy with unknown pediatric prevalence, which can present as neonatal intestinal obstruction. Case Presentations : A 2-week old, term male infant presented with abdominal distention and bilious vomiting. Upper gastrointestinal series ruled out malrotation. He improved with conservative management, but returned at 5 weeks of age with 2 weeks duration of obstipation, abdominal distention, vomiting and dehydration. Imaging studies showed dilated bowel loops, markedly redundant sigmoid colon consistent with dolichocolon. At exploration, dilated redundant sigmoid colon was resected with primary anastomosis. A premature female infant presented with intermittent feeding difficulties since birth, progressive abdominal distention, dilated bowel loops on imaging, and was treated conservatively. Contrast enema at 6 weeks of age demonstrated a redundant sigmoid colon, consistent with dolichocolon. Progressive abdominal distention and dilated bowel loops raised concerns for intermittent obstruction from volvulus. At exploration, dilated redundant sigmoid colon was resected with primary anastomosis. A preterm female infant presented during the first week of life with feeding difficulties, intermittent abdominal distention, obstipation and nonbilious vomiting. Imaging demonstrated distended loops of bowel and redundant sigmoid colon. Dilated redundant sigmoid colon was resected at 3 weeks of age, with satisfactory post-operative course. All patients were thriving well on long term follow-up at 6, 5 and 4 years, respectively. While rare, dolichocolon must be included in the differential diagnosis of neonates who develop intermittent intestinal obstruction.