Descending colon

Changed by Calum Worsley, 30 Mar 2023

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Disclosures - updated 12 Apr 2022: Nothing to disclose

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The descending colon is the continuation of the transverse colon after the left colic flexure, where the colon loses its mesentery.

Gross anatomy

The descending colon measures up to 25 cm in length and is secondarily retroperitoneal. It descends down attached to the left posterior abdominal wall into the left iliac fossa where it continues as the sigmoid colon. Peritoneum covers the anterior and lateral surfaces.

Relations

anteriorly: loops of small intestine, anterior abdominal wall, greater omentum
posteriorly: posterior abdominal wall
- distal descending colon crosses over external iliac and gonadal vessels
laterally: left paracolic gutter
medially: left infracolic space

Arterial supply

branches of inferior mesenteric artery
descending branch of left colic artery: proximal descending colon
sigmoid arteries: distal descending colon

Venous drainage

similarly named veins draining to the splenic vein and portal venous system

Lymphatic drainage

Lymphatics travel with vessels to the inferior mesenteric group.

Innervation

sympathetic: inferior mesenteric plexus
parasympathetic: via pelvic splanchnic nerves (S2-S4)

-<p>The<strong> descending colon</strong> is the continuation of the <a href="/articles/transverse-colon">transverse colon </a>after the <a href="/articles/left-colic-flexure">left colic flexure</a>, where the <a href="/articles/large-intestine-1">colon</a> loses its <a href="/articles/mesentery">mesentery</a>. </p><h4>Gross anatomy</h4><p>The descending colon measures up to 25 cm in length and is secondarily retroperitoneal. It descends down attached to the left posterior abdominal wall into the left iliac fossa where it continues as the <a href="/articles/sigmoid-colon">sigmoid colon</a>. <a href="/articles/peritoneum">Peritoneum</a> covers the anterior and lateral surfaces. </p><h5>Relations</h5><ul>
-<li>anteriorly: loops of <a href="/articles/small-bowel">small intestine</a>, <a href="/articles/anterior-abdominal-wall">anterior abdominal wall</a>, <a href="/articles/greater-omentum">greater omentum</a>
~~-</li>~~
-<li>posteriorly: <a href="/articles/posterior-abdominal-wall">posterior abdominal wall</a><ul><li>distal descending colon crosses over <a href="/articles/external-iliac-artery">external iliac</a> and gonadal vessels</li></ul>
~~-</li>~~
~~-<li>laterally: <a href="/articles/left-paracolic-gutter">left paracolic gutter</a>~~
~~-</li>~~
~~-<li>medially: <a href="/articles/left-inframesocolic-space">left infracolic space</a>~~
~~-</li>~~
~~-</ul><h4>Arterial supply</h4><ul>~~
~~-<li>branches of <a href="/articles/inferior-mesenteric-artery">inferior mesenteric artery</a>~~
~~-</li>~~
~~-<li>descending branch of<a href="/articles/left-colic-artery"> left colic artery</a>: proximal descending colon</li>~~
~~-<li>~~
~~-<a href="/articles/sigmoid-arteries">sigmoid arteries</a>: distal descending colon</li>~~
~~-</ul><h4>Venous drainage</h4><ul><li>similarly named veins draining to the <a href="/articles/splenic-vein">splenic vein</a> and <a href="/articles/portal-venous-system">portal venous system</a>~~
~~-</li></ul><h4>Lymphatic drainage</h4><p>Lymphatics travel with vessels to the inferior mesenteric group.</p><h4>Innervation</h4><ul>~~
~~-<li>~~
~~-<a title="Sympathetic nervous system" href="/articles/sympathetic-nervous-system-1">sympathetic</a>: <a href="/articles/inferior-mesenteric-plexus">inferior mesenteric plexus</a>~~
~~-</li>~~
~~-<li>~~
~~-<a href="/articles/parasympathetic-nervous-system">parasympathetic</a>: via <a href="/articles/parasympathetic-pelvic-splanchnic-nerves">pelvic splanchnic nerves</a> (S2-S4)</li>~~
+<p>The<strong> descending colon</strong> is the continuation of the <a href="/articles/transverse-colon">transverse colon </a>after the <a href="/articles/left-colic-flexure">left colic flexure</a>, where the <a href="/articles/large-intestine-1">colon</a> loses its <a href="/articles/mesentery">mesentery</a>. </p><h4>Gross anatomy</h4><p>The descending colon measures up to 25 cm in length and is secondarily retroperitoneal. It descends down attached to the left posterior abdominal wall into the left iliac fossa where it continues as the <a href="/articles/sigmoid-colon">sigmoid colon</a>. <a href="/articles/peritoneum">Peritoneum</a> covers the anterior and lateral surfaces. </p><h5>Relations</h5><ul>
+<li>anteriorly: loops of <a href="/articles/small-bowel">small intestine</a>, <a href="/articles/anterior-abdominal-wall">anterior abdominal wall</a>, <a href="/articles/greater-omentum">greater omentum</a>
+</li>
+<li>posteriorly: <a href="/articles/posterior-abdominal-wall">posterior abdominal wall</a><ul><li>distal descending colon crosses over <a href="/articles/external-iliac-artery">external iliac</a> and gonadal vessels</li></ul>
+</li>
+<li>laterally: <a href="/articles/left-paracolic-gutter">left paracolic gutter</a>
+</li>
+<li>medially: <a href="/articles/left-inframesocolic-space">left infracolic space</a>
+</li>
+</ul><h4>Arterial supply</h4><ul>
+<li>branches of <a href="/articles/inferior-mesenteric-artery">inferior mesenteric artery</a>
+</li>
+<li>descending branch of<a href="/articles/left-colic-artery"> left colic artery</a>: proximal descending colon</li>
+<li>
+<a href="/articles/sigmoid-arteries">sigmoid arteries</a>: distal descending colon</li>
+</ul><h4>Venous drainage</h4><ul><li>similarly named veins draining to the <a href="/articles/splenic-vein">splenic vein</a> and <a href="/articles/portal-venous-system">portal venous system</a>
+</li></ul><h4>Lymphatic drainage</h4><p>Lymphatics travel with vessels to the inferior mesenteric group.</p><h4>Innervation</h4><ul>
+<li>
+<a title="Sympathetic nervous system" href="/articles/sympathetic-nervous-system-1">sympathetic</a>: <a href="/articles/inferior-mesenteric-plexus">inferior mesenteric plexus</a>
+</li>
+<li>
+<a href="/articles/parasympathetic-nervous-system">parasympathetic</a>: via <a href="/articles/parasympathetic-pelvic-splanchnic-nerves">pelvic splanchnic nerves</a> (S2-S4)</li>

References changed:

1. Paul Butler, Adam Mitchell, Jeremiah C. Healy et al. Applied Radiological Anatomy. (2012) ISBN: 9780521766661 - <a href="http://books.google.com/books?vid=ISBN9780521766661">Google Books</a>
2. Cornelius Rosse, Penelope Gaddum-Rosse, William Henry Hollinshead. Hollinshead's Textbook of Anatomy. (1997) ISBN: 0397512562 - <a href="http://books.google.com/books?vid=ISBN0397512562">Google Books</a>
1. Butler P, Mitchell A, Healy JC. Applied Radiological Anatomy. (2012) ISBN:0521766664. <a href="http://books.google.com/books?vid=ISBN0521766664">Read it at Google Books</a> - <a href="http://www.amazon.com/gp/product/0521766664?ie=UTF8&tag=radiopaediaor-20&linkCode=as2&camp=1789&creative=9325&creativeASIN=0521766664">Find it at Amazon</a><div class="ref_v2"></div>
2. Rosse C, Gaddum-Rosse P, Hollinshead WH. Hollinshead's textbook of anatomy. Lippincott Williams & Wilkins. (1997) ISBN:0397512562. <a href="http://books.google.com/books?vid=ISBN0397512562">Read it at Google Books</a> - <a href="http://www.amazon.com/gp/product/0397512562?ie=UTF8&tag=radiopaediaor-20&linkCode=as2&camp=1789&creative=9325&creativeASIN=0397512562">Find it at Amazon</a><div class="ref_v2"></div>

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