Beji Hazem, Najib Fatma, Zaiem Asma, Guelbi Mohamed, Rebai Wael, Kacem Montassar
Department of General Surgery A, Hospital La Rabta, Tunis, Tunisia.
University Tunis El Manar, Faculty of Medicine of Tunis, Tunisia.
Ann Med Surg (Lond). 2022 Apr 22;77:103665. doi: 10.1016/j.amsu.2022.103665. eCollection 2022 May.
Idiopathic megabowel is a rare condition. Its physiopathology is still unclear. We report a case of a patient presenting with acute bowel obstruction due to idiopathic megacolon and megarectum that was successfully treated with proctocolectomy.
A 65-year-old man, with a history of chronic constipation, presented to the emergency with acute bowel obstruction symptoms.His CT scan on admission showed a very dilated rectum and sigmoid colon filled with faeces. The patient was managed conservatively.Due to the deterioration of his condition. We opted for an emergency laparotomy and it revealed the important dilation of the descending colon, the sigmoid colon, and the rectum leading to a Hartmann procedure.degenerative lesions of the smooth muscle layers were seen on the histopthological report and the diagnosis of rectosigmoid idiopathic megacolon was made.Postoperatively, we performed a rectoscopy that showed a distended rectum full of faeces.We performed a proctectomy with colo-anal anastomosis. He had an uneventful recovery.
Idiopathic megacolon is a rare condition. The pathogenesis is still unclear. Surgical treatment is the best option to prevent complications and to improve the quality of life of the patient.
特发性巨结肠是一种罕见疾病。其病理生理学仍不清楚。我们报告一例因特发性巨结肠和巨直肠导致急性肠梗阻的患者，该患者通过直肠结肠切除术成功治愈。
一名65岁男性，有慢性便秘病史，因急性肠梗阻症状就诊于急诊科。入院时的CT扫描显示直肠和乙状结肠极度扩张，充满粪便。患者接受了保守治疗。由于病情恶化，我们选择了急诊剖腹手术，术中发现降结肠、乙状结肠和直肠显著扩张，遂行哈特曼手术。组织病理学报告显示平滑肌层有退行性病变，诊断为直肠乙状结肠特发性巨结肠。术后，我们进行了直肠镜检查，发现直肠扩张，充满粪便。我们进行了直肠切除术并做了结肠肛管吻合术。患者恢复顺利。
特发性巨结肠是一种罕见疾病。其发病机制仍不清楚。手术治疗是预防并发症和提高患者生活质量的最佳选择。
