Mobile Right Colon Syndrome: Obscure Cause of Lower Right Abdominal Pain

The mobile right colon is a developmental aberration. During the development and rotation of the gut, the cecum and ascending colon are the last to take their final position and fuse with the posterior abdominal wall. Though a mobile right colon may be present in 20% - 30% of the population but causes symptoms in very few. The patients present intermittent colicky right lower quadrant abdominal pain with associated abdominal distention and symptomatic relief after passing flatus or having a bowel movement. Non fixation along with heavy load of the right colon drags the cecum and ascending colon down and leads to stasis, obstruction or volvulus. The diagnosis of this entity is very difficult as radiological studies are not conclusive. The mobile colon syndrome should be considered in the differential diagnosis of right lower quadrant pain from obscure causes. A proper detailed history is a must to consider this as differential diagnosis. Laparoscopy offers diagnostic and therapeutic treatment. Colopexy provides dramatic relief in carefully selected patients.