2017, Number 1
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Cir Gen 2017; 39 (1)
Toxic megacolon secondary to Hirschsprung’s disease. A case report
Soto PJA, Ledesma BR, Martínez RRP, Reynoso GR, San Román SJ
Language: Spanish
References: 13
Page: 33-36
PDF size: 220.81 Kb.
ABSTRACT
Hirschsprung’s disease, described in 1888, is defined as
the presence of less than 20% of normal ganglion cells
per milliliter of intestine. Some patients may present
with megacolon as a complication. We present the case
of a 46-year-old male with chronic constipation, with no
evacuations for one month, accompanied by vomiting,
abdominal distension and toxicity data. He presented with
acute abdomen; we performed an exploratory laparotomy,
in which we found dilatation of the sigmoid that covered
the whole abdominal cavity; left hemicolectomy was
performed, with colostomy at the transverse level. It
evolved in a torpid way and was intervened on the sixth day
to perform a colectomy plus ileostomy for presenting again
significant distention of the rest of the colon. The surgical
specimen was sent to histopathological study and reported
agangliosis, diagnosing Hirschsprung’s disease. The case
presented is extremely rare because Hirschsprung’s disease
is congenital, it is often diagnosed in childhood; when it is
not, it occurs in the adult with the symptoms mentioned;
however, the patient coursed with toxic megacolon, an
unusual situation.
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