Rare Case of Persistent Descending Mesocolon Identified on Cross-Sectional Imaging

Persistent descending mesocolon (PDM) is a congenital anatomical variant arising due to the failure of fusion of the descending mesocolon with the parietal peritoneum during fetal embryogenesis. In most individuals, this condition remains clinically silent and is detected incidentally on imaging or during abdominal surgery. However, its recognition is important because abnormal colonic mobility may predispose patients to future complications and may also influence surgical planning. We present a case of an 18-year-old female who came to the hospital with recurrent pain in the abdomen and was further evaluated with abdominal ultrasound and contrast-enhanced computed tomography (CECT), where imaging findings led to the diagnosis of PDM. CT imaging enabled the accurate identification of this entity while excluding intestinal malrotation and other acute abdominal pathology.