The sigmoid colon is a highly variable part of the gastrointestinal tract. Most of variations occupy the pelvis and lower abdomen and has a strong association with abdominal pathologies. We report a rare case of a high-reaching sigmoid colon which filled the entire space posterior to the anterior abdominal wall up to the lower border of the liver in the epigastrium.The case lacked typical colonic wall features such haustrations, taenia coli and appendices epiploicea. The case was not associated with apparent functional loss but had high a likelihood of malfunctioning through space-occupying effect, displacements and adhesions, disorders of transit of the digesta and disorders of vascular and neural supply. Reports of extreme anatomical variations of abdominal viscera are of clinical significance. More studies are needed to guide the clinicians for successful management of abdominal conditions with variant anatomy.
