Summary
In a series of 17 adult patients with megacolon, six seemed to have Hirschsprung’s disease. All were said to have had the disease in childhood and all had normal rectums, but biopsies were done in only two cases. One of the patients was treated conservatively, but he died of pneumonia two years later, and collapse of the lungs secondary to the distention of the colon appeared to be an important factor.
Three patients had excellent results after sigmoidal colectomy. Pull-through excision (one case) may have been unnecessarily radical.
Patients with idiopathic or acquired Hirschsprung’s disease have had less satisfactory results after surgery, and after sigmoidal colectomy in particular. If intensive medical treatment fails, total colectomy and ileorectal anastomosis may be the best procedure.
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References
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Hughes, E.S.R., Hardy, K.J. & Cuthbertson, A.M. Megacolon in adults. Dis Colon Rectum 12, 190–192 (1969). https://doi.org/10.1007/BF02617809
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DOI: https://doi.org/10.1007/BF02617809