The sigmoid Colon (colon sigmoideum; pelvic colon; sigmoid flexure) may be divided in two parts:
The Iliac part (Iliac Colon) is situated in the left iliac fossa, and is about 12 to 15 cm. long. It begins at the level of the iliac crest, where it is continuous with the descending colon, and ends in the sigmoid colon at the superior aperture of the lesser pelvis. It curves downward and medialward in front of the Iliacus and Psoas, and, as a rule, is covered by peritoneum on its sides and anterior surface only.
The pelvic part forms a loop which averages about 40 cm. in length, and normally lies within the pelvis, but on account of its freedom of movement it is liable to be displaced into the abdominal cavity. It begins at the superior aperture of the lesser pelvis, where it is continuous with the iliac colon, and passes transversely across the front of the sacrum to the right side of the pelvis; it then curves on itself and turns toward the left to reach the middle line at the level of the third piece of the sacrum, where it bends downward and ends in the rectum. It is completely surrounded by peritoneum, which forms a mesentery (sigmoid mesocolon), which diminishes in length from the center toward the ends of the loop, where it disappears, so that the loop is fixed at its junctions with the iliac colon and rectum, but enjoys a considerable range of movement in its central portion. Behind the sigmoid colon are the external iliac vessels, the left Piriformis, and left sacral plexus of nerves; in front, it is separated from the bladder in the male, and the uterus in the female, by some coils of the small intestine.