<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>1405-0099</journal-id>
<journal-title><![CDATA[Cirujano general]]></journal-title>
<abbrev-journal-title><![CDATA[Cir. gen]]></abbrev-journal-title>
<issn>1405-0099</issn>
<publisher>
<publisher-name><![CDATA[Asociación Mexicana de Cirugía General A.C.]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1405-00992017000100033</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Megacolon tóxico secundario a enfermedad de Hirschsprung. Reporte de un caso]]></article-title>
<article-title xml:lang="en"><![CDATA[Toxic megacolon secondary to Hirschsprung&#8217;s disease. A case report]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Soto Pérez]]></surname>
<given-names><![CDATA[Jorge Arturo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Ledesma Briseño]]></surname>
<given-names><![CDATA[Roberto]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Martínez Rubio]]></surname>
<given-names><![CDATA[Roberto Pablo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Reynoso González]]></surname>
<given-names><![CDATA[Ricardo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[San Román Sánchez]]></surname>
<given-names><![CDATA[Jesús]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado Hospital Regional &#8220;Lic. Adolfo López Mateos&#8221; Servicio de Coloproctología]]></institution>
<addr-line><![CDATA[Ciudad de México ]]></addr-line>
<country>México</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Instituto Mexicano del Seguro Social Hospital General de Zona #98 Servicio de Cirugía General]]></institution>
<addr-line><![CDATA[ Estado de México]]></addr-line>
<country>Mexico</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado Centro Médico &#8220;20 de Noviembre&#8221; ]]></institution>
<addr-line><![CDATA[Ciudad de México ]]></addr-line>
<country>México</country>
</aff>
<aff id="Af4">
<institution><![CDATA[,Instituto Mexicano del Seguro Social Hospital General de Zona #68 Servicio de Cirugía General]]></institution>
<addr-line><![CDATA[ Estado de México]]></addr-line>
<country>Mexico</country>
</aff>
<aff id="Af5">
<institution><![CDATA[,Instituto de Salud del Estado de México Hospital Regional de Alta Especialidad de Zumpango Servicio de Cirugía General]]></institution>
<addr-line><![CDATA[ Estado de México]]></addr-line>
<country>México</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>03</month>
<year>2017</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>03</month>
<year>2017</year>
</pub-date>
<volume>39</volume>
<numero>1</numero>
<fpage>33</fpage>
<lpage>36</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_arttext&amp;pid=S1405-00992017000100033&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_abstract&amp;pid=S1405-00992017000100033&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_pdf&amp;pid=S1405-00992017000100033&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen: La enfermedad de Hirschsprung, descrita en 1888, es definida como la presencia de menos de 20% de células ganglionares normales por milímetro de intestino. Algunos pacientes pueden cursar con megacolon como complicación. Presentamos el caso de un masculino de 46 años con estreñimiento crónico, con ausencia de evacuaciones durante un mes, acompañado de vómito, distensión abdominal y datos de toxicidad. Presentaba abdomen agudo y se realizó laparotomía exploradora, con la que se encontró dilatación del sigmoides que abarcaba la totalidad de la cavidad abdominal; se realizó hemicolectomía izquierda, con colostomía a nivel del transverso. Evolucionó de una manera tórpida y se reintervino al sexto día para realizar colectomía más ileostomía por presentar nuevamente distensión importante del resto del colon. Se envió la pieza quirúrgica a estudio histopatológico y reportaron agangliosis; se diagnosticó enfermedad de Hirschsprung. El caso que se presenta es sumamente raro debido a que la enfermedad de Hirschsprung es congénita, se diagnostica frecuentemente en la infancia; cuando no es de esta manera, se presenta en el adulto con los síntomas mencionados; sin embargo, el paciente cursó con megacolon tóxico, una situación inusual.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract: Hirschsprung&#8217;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&#8217;s disease. The case presented is extremely rare because Hirschsprung&#8217;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.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Hirschsprung]]></kwd>
<kwd lng="es"><![CDATA[megacolon tóxico]]></kwd>
<kwd lng="en"><![CDATA[Hirschsprung]]></kwd>
<kwd lng="en"><![CDATA[toxic megacolon]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<label>1</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Peña]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Levitt]]></surname>
<given-names><![CDATA[MA]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Pediatric surgical problems]]></article-title>
<person-group person-group-type="editor">
<name>
<surname><![CDATA[Corman]]></surname>
<given-names><![CDATA[ML]]></given-names>
</name>
</person-group>
<source><![CDATA[Corman&#8217;s colon and rectal surgery]]></source>
<year>2013</year>
<edition>6</edition>
<page-range>556-69</page-range><publisher-loc><![CDATA[Philadelphia ]]></publisher-loc>
<publisher-name><![CDATA[Lippincott Williams &amp; Wilkins]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B2">
<label>2</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Teitelbaum]]></surname>
<given-names><![CDATA[DH]]></given-names>
</name>
<name>
<surname><![CDATA[Ehrlich]]></surname>
<given-names><![CDATA[PF]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Pediatric colorectal disorders]]></article-title>
<person-group person-group-type="editor">
<name>
<surname><![CDATA[Steele]]></surname>
<given-names><![CDATA[SR]]></given-names>
</name>
<name>
<surname><![CDATA[Hull]]></surname>
<given-names><![CDATA[TL]]></given-names>
</name>
<name>
<surname><![CDATA[Read]]></surname>
<given-names><![CDATA[TE]]></given-names>
</name>
<name>
<surname><![CDATA[Saclarides]]></surname>
<given-names><![CDATA[TJ]]></given-names>
</name>
<name>
<surname><![CDATA[Senagore]]></surname>
<given-names><![CDATA[AJ]]></given-names>
</name>
<name>
<surname><![CDATA[Whitlow]]></surname>
<given-names><![CDATA[CB]]></given-names>
</name>
</person-group>
<source><![CDATA[The ASCRS textbook of colon and rectal surgery]]></source>
<year>2016</year>
<edition>3</edition>
<page-range>1140-2</page-range><publisher-loc><![CDATA[Illinois ]]></publisher-loc>
<publisher-name><![CDATA[Springer]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B3">
<label>3</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Qiu]]></surname>
<given-names><![CDATA[JF]]></given-names>
</name>
<name>
<surname><![CDATA[Shi]]></surname>
<given-names><![CDATA[YJ]]></given-names>
</name>
<name>
<surname><![CDATA[Hu]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Fang]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Wang]]></surname>
<given-names><![CDATA[HF]]></given-names>
</name>
<name>
<surname><![CDATA[Zhang]]></surname>
<given-names><![CDATA[MC]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Adult Hirschsprung&#8217;s disease: report of four cases]]></article-title>
<source><![CDATA[Int J Clin Exp Pathol]]></source>
<year>2013</year>
<volume>6</volume>
<page-range>1624-30</page-range></nlm-citation>
</ref>
<ref id="B4">
<label>4</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Bakari]]></surname>
<given-names><![CDATA[AA]]></given-names>
</name>
<name>
<surname><![CDATA[Gali]]></surname>
<given-names><![CDATA[BM]]></given-names>
</name>
<name>
<surname><![CDATA[Ibrahim]]></surname>
<given-names><![CDATA[AG]]></given-names>
</name>
<name>
<surname><![CDATA[Nggada]]></surname>
<given-names><![CDATA[HA]]></given-names>
</name>
<name>
<surname><![CDATA[Ali]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Dogo]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Congenital aganglionic megacolon in Nigerian adults: two case reports and review of the literature]]></article-title>
<source><![CDATA[Niger J Clin Pract]]></source>
<year>2011</year>
<volume>14</volume>
<page-range>249-52</page-range></nlm-citation>
</ref>
<ref id="B5">
<label>5</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Vorobyov]]></surname>
<given-names><![CDATA[GI]]></given-names>
</name>
<name>
<surname><![CDATA[Achkasov]]></surname>
<given-names><![CDATA[SI]]></given-names>
</name>
<name>
<surname><![CDATA[Biryukov]]></surname>
<given-names><![CDATA[OM]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Clinical features&#8217; diagnostics and treatment of Hirschsprung&#8217;s disease in adults]]></article-title>
<source><![CDATA[Colorectal Dis]]></source>
<year>2010</year>
<volume>12</volume>
<page-range>1242-8</page-range></nlm-citation>
</ref>
<ref id="B6">
<label>6</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Alagumuthu]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Jagdish]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Kadambari]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Hirschsprung&#8217;s disease in adults presenting as sigmoid volvulus: a report of three cases]]></article-title>
<source><![CDATA[Trop Gastroenterol]]></source>
<year>2011</year>
<volume>32</volume>
<page-range>341-3</page-range></nlm-citation>
</ref>
<ref id="B7">
<label>7</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[B&#259;l&#259;nescu]]></surname>
<given-names><![CDATA[RN]]></given-names>
</name>
<name>
<surname><![CDATA[B&#259;l&#259;nescu]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Moga]]></surname>
<given-names><![CDATA[AA]]></given-names>
</name>
<name>
<surname><![CDATA[Dr&#259;gan]]></surname>
<given-names><![CDATA[GC]]></given-names>
</name>
<name>
<surname><![CDATA[Djendov]]></surname>
<given-names><![CDATA[FB]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Segmental aganglionosis in Hirschsprung&#8217;s disease in newborns -a case report]]></article-title>
<source><![CDATA[Rom J Morphol Embryol]]></source>
<year>2015</year>
<volume>56</volume>
<page-range>533-6</page-range></nlm-citation>
</ref>
<ref id="B8">
<label>8</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Agrawal]]></surname>
<given-names><![CDATA[RK]]></given-names>
</name>
<name>
<surname><![CDATA[Kakkar]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Vasishta]]></surname>
<given-names><![CDATA[RK]]></given-names>
</name>
<name>
<surname><![CDATA[Kumari]]></surname>
<given-names><![CDATA[V]]></given-names>
</name>
<name>
<surname><![CDATA[Samujh]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Rao]]></surname>
<given-names><![CDATA[KL]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Acetylcholinesterase histochemistry (AchE) -A helpful technique in the diagnosis and in aiding the operative procedures of Hirschsprung disease]]></article-title>
<source><![CDATA[Diagn Pathol]]></source>
<year>2015</year>
<volume>10</volume>
<page-range>208</page-range></nlm-citation>
</ref>
<ref id="B9">
<label>9</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Luzón-Toro]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Espino-Paisán]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Fernández]]></surname>
<given-names><![CDATA[RM]]></given-names>
</name>
<name>
<surname><![CDATA[Martín-Sánchez]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Antiñolo]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Borrego]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Next-generation-based targeted sequencing as an efficient tool for the study of the genetic background in Hirschsprung patients]]></article-title>
<source><![CDATA[BMC Med Genet]]></source>
<year>2015</year>
<volume>16</volume>
<page-range>89</page-range></nlm-citation>
</ref>
<ref id="B10">
<label>10</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Tang]]></surname>
<given-names><![CDATA[YF]]></given-names>
</name>
<name>
<surname><![CDATA[Chen]]></surname>
<given-names><![CDATA[JG]]></given-names>
</name>
<name>
<surname><![CDATA[An]]></surname>
<given-names><![CDATA[HJ]]></given-names>
</name>
<name>
<surname><![CDATA[Jin]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Yang]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Dai]]></surname>
<given-names><![CDATA[ZF]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[High-resolution anorectal manometry in newborns: normative values and diagnostic utility in Hirschsprung disease]]></article-title>
<source><![CDATA[Neurogastroenterol Motil]]></source>
<year>2014</year>
<volume>26</volume>
<page-range>1565-72</page-range></nlm-citation>
</ref>
<ref id="B11">
<label>11</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Swaminathan]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Oron]]></surname>
<given-names><![CDATA[AP]]></given-names>
</name>
<name>
<surname><![CDATA[Chatterjee]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Piper]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
<name>
<surname><![CDATA[Cope-Yokoyama]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Chakravarti]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Intestinal neuronal dysplasia-like submucosal ganglion cell hyperplasia at the proximal margins of Hirschsprung disease resections]]></article-title>
<source><![CDATA[Pediatr Dev Pathol]]></source>
<year>2015</year>
<volume>18</volume>
<page-range>466-76</page-range></nlm-citation>
</ref>
<ref id="B12">
<label>12</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Zhang]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Li]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Wu]]></surname>
<given-names><![CDATA[Y]]></given-names>
</name>
<name>
<surname><![CDATA[Hu]]></surname>
<given-names><![CDATA[Y]]></given-names>
</name>
<name>
<surname><![CDATA[Duan]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Wang]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Comparison of laparoscopic-assisted operations and laparotomy operations for the treatment of Hirschsprung disease: evidence from a meta-analysis]]></article-title>
<source><![CDATA[Medicine (Baltimore)]]></source>
<year>2015</year>
<volume>94</volume>
</nlm-citation>
</ref>
<ref id="B13">
<label>13</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Autenrieth]]></surname>
<given-names><![CDATA[DM]]></given-names>
</name>
<name>
<surname><![CDATA[Baumgart]]></surname>
<given-names><![CDATA[DC]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Toxic megacolon]]></article-title>
<source><![CDATA[Inflamm Bowel Dis]]></source>
<year>2012</year>
<volume>18</volume>
<page-range>584-91</page-range></nlm-citation>
</ref>
</ref-list>
</back>
</article>
