Abstract
Sigmoid volvulus is a rare presentation of Hirschsprung’s disease. A 38-year-old male presented with acute intestinal obstruction and a history of chronic constipation since childhood. Abdominal radiographs showed megarectum and megacolon with issipated feces. Sigmoidoscopy revealed gangrenous bowel mucosa affecting the sigmoid colon. Emergency laparotomy revealed a grossly dilated bowel with concurrent gangrenous sigmoid volvulus. He was treated successfully with proctocolectomy with J-pouch-anal anastomosis and a defunctioning ileostomy. Histological analysis was consistent with short segment Hirschsprung’s disease. Although uncommon, adult Hirschsprung’s disease is a cause of chronic constipation and can present acutely with a sigmoid volvulus. Mortality in cases with sigmoid volvulus is greater than in cases without (15.4% vs. 0%). A better awareness of this condition will facilitate management.
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Tan, F.L.S., Tan, YM., Heah, S.M. et al. Adult Hirschsprung’s disease presenting as sigmoid volvulus: a case report and review of literature. Tech Coloproctol 10, 245–248 (2006). https://doi.org/10.1007/s10151-006-0288-8
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DOI: https://doi.org/10.1007/s10151-006-0288-8