Idiopathic megacolon and megarectum in an adult treated with laparoscopic modified Duhamel procedure

Idiopathic megacolon (IMC) and idiopathic megarectum (IMR) describe an abnormality of the colon or rectum, characterised by a permanent dilatation of the bowel diameter in the absence of an identifiable cause. We present a 23-year-old woman with chronic constipation and excessive straining during de...

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Bibliographic Details
Published in:BMJ case reports 2021-06, Vol.14 (6), p.e240209
Main Authors: Villanueva, Maureen Elvira Padernal, Lopez, Marc Paul Jose, Onglao, Mark Augustine S
Format: Article
Language:English
Subjects:
Adult
Adults
Biopsy
Case Report
Case reports
Colon
Constipation
Constipation - etiology
Constipation - surgery
Disease
Female
Hirschsprung Disease - surgery
Hospitals
Humans
Laparoscopy
Laxatives
Megacolon - diagnostic imaging
Megacolon - surgery
Ostomy
Patients
Rectum
Rectum - surgery
Young Adult
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Summary:Idiopathic megacolon (IMC) and idiopathic megarectum (IMR) describe an abnormality of the colon or rectum, characterised by a permanent dilatation of the bowel diameter in the absence of an identifiable cause. We present a 23-year-old woman with chronic constipation and excessive straining during defecation who presented at the emergency department in partial gut obstruction with a palpable fecaloma. Manual faecal disimpaction and a sigmoid loop colostomy was initially done. A full thickness rectal biopsy was positive for ganglion cells. Further workup led to the diagnosis of chronic IMC and IMR. The patient underwent laparoscopic modified Duhamel procedure, with an uneventful postoperative course.
ISSN:1757-790X
1757-790X
DOI:10.1136/bcr-2020-240209