Adhi Mehreen, Khan Salma, Zafar Hasnain, Arshad Muhammad
Department of Surgery, The Aga Khan University Hospital, Karachi.
J Coll Physicians Surg Pak. 2012 Jun;22(6):395-7.
An adult presented with chronic constipation and abdominal mass. Clinical features, abdominal radiographs and barium enema revealed features consistent with Hirschsprung's disease. Full-thickness rectal biopsy was planned, but patient was lost to follow-up and presented 3 years later with intestinal obstruction. Exploratory laparotomy with resection of affected sigmoid colon and end colostomy were performed. Sequential rectal biopsies were obtained during the procedure to confirm the diagnosis. Later, Duhamel's procedure with a diverting loop ileostomy was successfully performed. Ileostomy reversal was done thereafter. There was complete resolution of symptoms and dramatic improvement in bowel function.
一名成年人出现慢性便秘和腹部肿块。临床特征、腹部X光片和钡灌肠显示出与先天性巨结肠一致的特征。计划进行全层直肠活检，但患者失访，3年后因肠梗阻再次就诊。进行了剖腹探查术，切除受累的乙状结肠并做了结肠造口术。术中进行了连续直肠活检以确诊。后来，成功实施了带转流性回肠造口术的杜哈梅尔手术。此后进行了回肠造口还纳术。症状完全缓解，肠道功能显著改善。
