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Cirujano general

versão impressa ISSN 1405-0099

Resumo

SOTO PEREZ, Jorge Arturo et al. Toxic megacolon secondary to Hirschsprung’s disease. A case report. Cir. gen [online]. 2017, vol.39, n.1, pp.33-36.  Epub 26-Mar-2020. ISSN 1405-0099.

Hirschsprung’s disease, described in 1888, is defined as the presence of less than 20% of normal ganglion cells per milliliter of intestine. Some patients may present with megacolon as a complication. We present the case of a 46-year-old male with chronic constipation, with no evacuations for one month, accompanied by vomiting, abdominal distension and toxicity data. He presented with acute abdomen; we performed an exploratory laparotomy, in which we found dilatation of the sigmoid that covered the whole abdominal cavity; left hemicolectomy was performed, with colostomy at the transverse level. It evolved in a torpid way and was intervened on the sixth day to perform a colectomy plus ileostomy for presenting again significant distention of the rest of the colon. The surgical specimen was sent to histopathological study and reported agangliosis, diagnosing Hirschsprung’s disease. The case presented is extremely rare because Hirschsprung’s disease is congenital, it is often diagnosed in childhood; when it is not, it occurs in the adult with the symptoms mentioned; however, the patient coursed with toxic megacolon, an unusual situation.

Palavras-chave : Hirschsprung; toxic megacolon.

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