Abstract

ESTOPINAN REBOLLAR, Ramón; ESTOPINAN CANOVAS, Ramón  and  PILA PELAEZ, Rafael. Hirschsprung’s Disease in an Adult Patient. Rev Col Gastroenterol [online]. 2016, vol.31, n.1, pp.52-55. ISSN 0120-9957.

Objective: This study presents a rare case of Hirschsprung’s disease in an adult. Case Report: The patient was a 32 year old man with severe intellectual and mental retardation from a poorly educated family. Since childhood, he had had a history of episodes of constipation which was relieved with laxatives and for which he had been admitted on many occasions to the Children’s Hospital of his province. Hirschsprung’s disease was diagnosed with a barium enema and rectal manometry. Surgery was recommended, but his family did not give their permission. When he arrived at the hospital, he told doctors that he had not had a bowel movement for 83 days. Physical examination showed a globular, asymmetrical abdomen with a 30x 15cm palpable tumor in the right abdomen. Digital rectal examination showed  normal sphincter muscle tone and an empty rectal ampulla. Bowel sounds were minimal. The analytical study was normal. Standing and prone abdominal radiography showed x-ray opacity compatible with fecal matter. Hartmann’s procedure was performed to resolve the acute situation. Surgery revealed  aganglionic megacolon which was confirmed by histopathology. The patient was asymptomatic while awaiting definitive surgical treatment. Conclusions: Hirschsprung’s disease is rare in adults, and must be distinguished from other causes of megacolon. Its etiology is unknown, although it is considered multifactorial. The first and most important symptom is constipation. Diagnosis requires imaging and rectal manometry and confirmation by histopathology. Treatment is always surgical.

Keywords : Adult Hirschsprung’s disease.

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