A Case of Chronic Intestinal Psudo-obstruction with Megacolon

Takuro Saito, Tomozo Ejiri*, Shunichi Ishii, Hitoshi Inoue, Ryouichi Motoki

First Department of Surgery, Fukushima Medical College
*Department of Surgery, Iwaki Municipal Hospital

A case of chronic intestinal pseudo-obstruction with megacolon due to segmental colonic oligoganglionosis is reported. A 57-year-old woman with no known history of difficulty in defecation in her childhood was admitted to our hospital complaining of severe abdominal distension and periodic abdominal pain. Plain abdominal X-ray film showed marked dilatation of the ascending and transverese colon with fluid. Barium enema examination revealed the descending colon to be poorly distended with marked dilatation proximal to it. As ileus was not relieved by conservative therapy, transverse colostomy was performed, and a secondary, narrow part of the colon was resected. Histological examination revealed a marked decrease in the number of normal ganglion cells in both Auerbach's plexus and Meissner's plexus in the affected part of the resected specimen. At 10 months after surgery, her clinical course is good and she is alive.

Key words
chronic intestinal pseudo-obstruction, megacolon, colonic oligoganglionosis

Reprint requests
Takuro Saito First Department of Surgery, Fukushima Medical College
1 Hikarigaoka, Fukushima-shi, 960 JAPAN

Accepted
September 4, 1991

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