Congenital megacolon in the adult. Report of 15 cases
Parc, R.; Douvin, D.; Loygue, J.
Gastroenterologie Clinique et Biologique 3(4): 321-328
1979
ISSN/ISBN: 0399-8320 PMID: 499694 Document Number: 149666
In 15 patients aged 15 yr or more, the diagnosis of Hirchsprung's disease was based on the following criteria: delay in passing meconium (5 cases); constipation since birth; no other mental or physical abnormality. Ba enema demonstrated marked dilatation of the left colon contrasting with a normal-sized rectum and sigmoid. Since diagnosis was obvious on Ba enema, it was confirmed only in 4 cases by rectal biopsy prior to surgery. Pathologic examination of the resected colon demonstrated the absence of myenteric ganglion cells extending from the anal sphincter up to the lower sigmoid. Ganglion cells were normal above this level without any transition. Fourteen patients were treated by Duhamel's operation with a follow-up of 18 mo. of 14 yr. In 4 patients, temporary colostomy was performed because of pelvic sepsis. One patient had to be reoperated upon as a consequence of stenosis of the colo-rectal anastomosis; stenosis did not recur. There were no genito-urinary complications.