| 篇名 |
Intractable constipation in an adult with megarectosigmoid following repair of low-type anorectal malformation |
| 作者 |
Yao-Jen Hsu, Yu-Wei Fu, Chin-Hung Wei, Min-Jen Chen |
| 卷期/出版年月 |
50卷1期 (2017/2) |
| 頁次 |
40-43 |
| 摘要 |
A 55-year-old male patient received an anoplasty at infancy for low-type anorectal malformation, and intractable constipation was observed since. The patient presented with colitis at the emergency department. Computed
tomography revealed feces with a megarectosigmoid of diameter 18 cm. Hirschsprung disease was suspected on the basis of the imaging findings. Therefore, a rectal biopsy was performed, which indicated the presence
of normal ganglion cells. Bowel management was implemented with one large-volume enema to empty the huge rectal pouch daily. The patient was free of constipation and had an improved nutritional status with appropriate weight gain in 3 months. A laparoscopic Swenson pull-through was performed. The hospital course was uneventful. Enemas, loperamide, and water-soluble fibers were required for frequent soiling because of postoperative hypermotile colon. The treatments were weaned off gradually. At the latest follow-up
(2 years postoperatively), the patient had regular voluntary bowel movements with complete bowel control. |
| 關鍵詞 |
Anorectal malformations, bowel management, constipation, megarectosigmoid, laparoscopy, Swenson pull-through |
| 分類 |
Case report |
