Abstract. ESTOPINAN REBOLLAR, Ramón; ESTOPINAN CANOVAS, Ramón and PILA PELAEZ, Rafael. Enfermedad de Hirschsprung en un adulto. Rev Col. Resumen. LOMBANA, Luis Jorge y DOMINGUEZ, Luis Carlos. Surgery in adult Hirschsprung’s disease. Rev Col Gastroenterol [online]. , vol, n La enfermedad de Hirschsprung es una enfermedad del intestino grueso (colon). Normalmente, las heces fecales son empujadas a través del colon por.

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Discussion HD is a congenital anomaly that occurs due to a discontinuation of the cranial-caudal migration of neural crest cells, which are responsible for innervation of the colon, or when the ganglion cells undergo premature death between 5th and 12th weeks of pregnancy.

Hirschsprung’s disease in a young adult: In our case, we are in a situation of irreversible dilatation of entire colon, so we opted for a total colectomy, restoring intestinal transit by ileo-rectal anastomosis. The rectal biopsy should be made hirschsprumg the back side of rectum, about 6 cm height, and it shows absence of ganglion cells, nerve fibers hyperplasia and an increased level of acetylcholinesterase 7.

Case Reports Late diagnosis of Hirschsprung’s disease. As background, he reported fecal incontinence with encopresis since he was 12 year-old, initially ascribed to a child psychiatric disorder. Bowel sounds were minimal. A full-thickness biopsy was taken from the wall of the rectum, with the following findings: A year-old man came to the emergency room adultod of diarrhea of 4 weeks duration, accompanied by constipation.

Please cite this article as: Postoperative evolution was torpid, with difficulty feedback by adynamic ileus and infection of surgical wound. Treatment is always surgical. Hirschsprung’s disease as a rare cause of refractory constipation in an adult patient. Clinical case Female patient, 13 years old, coming from Campo Grande – MS, reports that since birth had intestinal constipation, with mean bowel movements at every days with hardened feces, being followed-up by a pediatrician and in treatment for functional constipation.


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Surgery was recommended, but his family did not give their permission. Rev Col Gastroenterol, 22pp.

Cirugía en la enfermedad de Hirschsprung del adulto

Enfermedad de Hirschsprung en adultos. Complaints of fecal incontinence are often reported in the literature in cases of functional constipation and of idiopathic megacolon. A CT scan is a useful tool, not only to show the transition zone, but to exclude other causes of chronic constipation and megacolon in adults, such as colorectal cancer, volvulus, stricture, slowing of colonic motility, Chagas disease, anatomical or functional obstruction to defecation or idiopathic megacolon adultso.

Emergency surgery was indicated, performing an anastomosis resection and end ileostomy. South Med J ; HD presents itself by symptoms of constipation, such as a greater than h delay in elimination of meconium, abdominal distention and vomiting.

Vólvulo en adultos

adultoos Agonglinosis is pathgnomonic for HD. Hirschsprung Disease HD or Congenital Megacolon is an anomaly that is characterized mainly for the absence of ganglion cells in the myenteric plexus and submucosal in a variable segment of the intestine.

CiteScore measures average citations received per document published. A barium enema study identified megarectum fig. Under a Creative Commons license.

After that, the palpable mass disappeared, but clinical constipation persisted.

Standing and prone abdominal radiography showed x-ray opacity compatible with fecal matter. The treatment is surgical, in order to remove the aganglionic segment and restore digestive continuity. The infrequency of this diagnosis in this age and the clinical course of this patient underscore the uniqueness of this case. For our patient, fecal incontinence is a more limiting symptom than the constipation itself, because the girl was living in constant fear of occurrence of such fact in environments like her school, which would cause great embarrassment before other people.


Barium enema showing megarectum. Print Send to a friend Export reference Mendeley Statistics.

Peripheral aerial imagery was found in the dilated segment, gas-like wall, which is thickened in this segment. The age of patients ranges from 10 to 73 years old.

With this technique an extensive dissection of the anterior wall of the rectum is avoided, thus avoiding the risk of injuring adjacent structures. A resection of distal rectal mucosa of hirschspprung aganglionic segment is performed, maintaining muscular wall of this segment.

Barium enema showing megarectum. It consists in a rear section of muscular wall of rectum starting from dentate line by transanal waywhich removes some of the top segment of internal anal sphincter, getting relief stenosis. Most cases become manifest d the neonatal period, but in rare instances, this disease is initially diagnosed in adult age.

This factor contributed to the delay in her diagnosis, driving the pediatrician out of a HD hypothesis.

The Congenital Megacolon presents agonglionosis in different lengths of the intestine; many times associated to other congenital anomalies. Niger J Clin Pract ;