Morphometric Analysis of Redundant Sigmoid Colon in Patients with Difficult Colonoscopy: A Gender-Based Study

Redundant sigmoid colon complicates colonoscopy but remains underreported in radiological practice. Comprehensive morphometric data in the Turkish population are lacking. This study aimed to determine the prevalence and morphometric characteristics of redundant sigmoid colon in patients with difficult colonoscopy and analyze gender-related differences. We retrospectively reviewed 2458 colonoscopy reports from a university hospital (October 2023-October 2024). Cases meeting colonoscopic criteria for redundancy (≥2 of: prolonged advancement time, loop formation, position changes, scope >90 cm) underwent CT-based morphometric analysis (n=86). Measurements included sigmoid dimensions, muscle thickness, subcutaneous fat, and anatomical distances using 3D Slicer software. Prevalence was 6.14% (151/2458). Among 86 analyzed cases, 76.7% were female. Despite colonoscopic diagnosis, radiologists failed to report redundancy in 94.2% of cases. Most cases (87.2%) showed rightward initial curvature with ≥3 acute-angle curves (