Werner CR, Stoltenburg-Didinger G, Weidemann H, Benckert C, Schmidtmann M, Voort IRVD, Andresen V, Klapp BF, Neuhaus P, Wiedenmann B, Mönnikes H. Megacolon in adulthood after surgical treatment of Hirschsprung’s disease in early childhood. World J Gastroenterol 2005; 11(36): 5742-5745 [PMID: 16237779 DOI: 10.3748/wjg.v11.i36.5742]
Corresponding Author of This Article
Hubert Mönnikes, MD MSc; Department of Medicine, Division of Hepatology and Gastroenterology; Charité, Campus Virchow-Klinikum; Universitätsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin, Germany. moennikes@web.de
Article-Type of This Article
Case Report
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World J Gastroenterol. Sep 28, 2005; 11(36): 5742-5745 Published online Sep 28, 2005. doi: 10.3748/wjg.v11.i36.5742
Megacolon in adulthood after surgical treatment of Hirschsprung’s disease in early childhood
Christoph R. Werner, Gisela Stoltenburg-Didinger, Henning Weidemann, Christoph Benckert, Marco Schmidtmann, Ivo R. van der Voort, Viola Andresen, Burghard F. Klapp, Peter Neuhaus, Bertram Wiedenmann, Hubert Mönnikes
Christoph R. Werner, Bertram Wiedenmann, Hubert Mönnikes, Department of Medicine, Division of Hepatology and Gastroenterology, Charité, Campus Virchow-Klinikum, Universitätsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin, Germany
Gisela Stoltenburg-Didinger, Department of Neuropathology, Charité, Campus Virchow-Klinikum, Universitätsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin, Germany
Marco Schmidtmann, Ivo R. van der Voort, Viola Andresen, Burghard F. Klapp, Department of Medicine, Division of Psychosomatic Medicine and Psychotherapy, Charité, Campus Mitte Luisenstraße 13 A, D-10117 Berlin, Germany
Christoph Benckert, Henning Weidemann, Peter Neuhaus, Department of General, Visceral and Transplantation Surgery, Charité, Campus Virchow-Klinikum, Universitätsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin, Germany
Author contributions: All authors contributed equally to the work.
Correspondence to: Hubert Mönnikes, MD MSc; Department of Medicine, Division of Hepatology and Gastroenterology; Charité, Campus Virchow-Klinikum; Universitätsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin, Germany. moennikes@web.de
Telephone: +49-30-450653391 Fax: +49-30-450553991
Received: July 23, 2004 Revised: January 2, 2005 Accepted: January 5, 2005 Published online: September 28, 2005
Abstract
Hirschsprung’s disease (HD) is a disorder associated with congenital malformation of the enteric nervous system with segmental aganglionosis. Prevailing therapy includes a resection of the affected part of the bowel. However, patients often do not obtain complete functional improvement after surgical treatment. We present the case of a 25-year-old woman who had surgical treatment of HD in early childhood. After that procedure she had clinical features of constipation for years in the end, passing of stool once a week, requiring laxatives and enemas. We diagnosed an incomplete resection of the aganglionic bowel via rectal biopsy and resected the remaining aganglionic segment. Two months after surgery the patient’s bowel function improved to a frequency of 1-4 stools per day. We conclude that regular follow-up is required to identify HD patients with persistent alterations of bowel function after surgery. In patients presenting with constipation, recognition of a remaining aganglionic segment or other alterations of the enteric nervous system should be aimed at in an early stage.
