An Operated Case of Segmental Hypoganglionosis of the Colon

概要

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A 70-year-old Japanese male complaining of abdominal distention and constipation was admitted to our hospital. Abdominal X-ray and computed tomography revealed dilatation and fecal impaction of the right-side colon. Barium enema also showed dilatation of the right-side colon. Colonoscopy did not show any mucosal change or organic stenosis of the colon. A colonic transit time test showed that the flow of the marker slowed down before the descending lesion. Because conservative therapy was not effective, subtotal colon resection was performed, following which the fecal condition and symptoms improved. Pathological examination showed a decrease of the number of neural plexus and ganglion cells, and a diagnosis of segmental hypoganglionosis (SH) of the descending colon causing functional stenosis was made. SH is very rare and often resists conservative therapy, but resection of the stenotic colon can improve the symptoms of SH. Therefore, surgery should be considered for functional colonic stenosis that resists usual conservative therapy.