Intractable constipation in an adult with megarectosigmoid following repair of low-Type anorectal malformation

Yao Jen Hsu, Yu Wei Fu, Chin Hung Wei, Min Jen Chen

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)40-43
Number of pages4
JournalFormosan Journal of Surgery
Volume50
Issue number1
DOIs
Publication statusPublished - Jan 1 2017
Externally publishedYes

Keywords

  • Anorectal malformations
  • Bowel management
  • Constipation
  • Laparoscopy
  • Megarectosigmoid
  • Swenson pull-Through

ASJC Scopus subject areas

  • Surgery

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