The Two Case Reports of Hirschsprung's Disease in Adult

Satoshi Taniwaki, Hiroshi Ito, Hideji Zennami, Toshinari Yamashita, Yukio Terashita, Kyuji Honda and Takeshi Eguchi^*

Department of Surgery, Nagoya Manicipal Johoku Hospital Department of Surgery^*, Nagoya City Higashi General Hospital

Hirschsprung's disease is characteristically presents in infancy or childhood, with symptoms of severe constipation and abdominal distension. Surgical treatment is almost always completed in childhood. We report 2 cases of Hirschsprug's disease in adults. Case 1: A 23-year-old man was referred to our hospital with worsened constipation and abdominal distension and abdominal pain. Case 2: A 47-year-old woman consulted us about pyrexia, diarrhea, appetite loss, and weight loss of 9kg in 2 months. Secondary colitis mimicking inflammatory bowel disease such as Crohn's disease or ulcerative colitis was obvious in case 2, associated with long-term massive feces retention. In both cases, severe constipation had been presented since childhood, but controllable with laxatives and enemas. Barium-enema showed caliber change in the lower rectum, and the rectoanal reflex was absent in the manometric study. The Duhamel-Ikeda procedure was conducted and the postoperative course was uneventful. Quality of life improved markedly in both cases. Pediatric surgery was recently instituted and Hirschsprug's disease rarely remains undiagnosed until adulthood. It should, however, be considered in all adult patients who have had severe constipation since childhood involving the megacolon.

Key words
Hirschsprung's disease, adult, obstructive colitis

Reprint requests
Satoshi Taniwaki Department of Surgery, Nagoya Manicipal Johoku Hospital 2-15, Kanada-cho, Kita-ku, Nagoya, 462-0033 JAPAN

Accepted
June 26, 2001

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