Dahal Prajwal, Dawadi Kapil, Parajuli Sabina
Department of Radiology and Imaging, Grande International Hospital, Tokha, Kathmandu, Bagmati, 11796, Nepal.
Department of Pathology, Bir Hospital, Mahabauddha, Kathmandu, Bagmati, 44600, Nepal.
BJR Case Rep. 2024 Jan 30;10(1):uaae003. doi: 10.1093/bjrcr/uaae003. eCollection 2024 Jan.
Congenital sigmoid colon stenosis is a rare entity that can mimic Hirschsprung disease. Presentation of congenital colon stenosis is usually within first few weeks of life. Our case presented with features of distal bowel obstruction at 2 years of age with the history of chronic constipation and progressive abdominal distention from first week of life and bilious vomiting for the last 1 week. Clinical diagnosis of Hirschsprung disease was made. Contrast enhanced CT abdomen showed bowel obstruction with transition point at the level of proximal sigmoid colon. There was a short segment stenosis at the level of proximal sigmoid colon. Contrast enema showed stenosis at proximal sigmoid colon. The bowel distal to stenosis was normal in calibre. Similar findings were seen during surgery. Mesocolon was present in stenosed segment of the bowel. The resected stenotic segment showed adequate ganglion cells in histopathology.
先天性乙状结肠狭窄是一种罕见的疾病,可类似先天性巨结肠。先天性结肠狭窄通常在出生后的头几周出现。我们的病例在2岁时表现为远端肠梗阻,有慢性便秘病史,自出生第一周起逐渐出现腹胀,最近1周出现胆汁性呕吐。临床诊断为先天性巨结肠。腹部增强CT显示肠梗阻,移行段位于乙状结肠近端。乙状结肠近端有短段狭窄。结肠造影显示乙状结肠近端狭窄。狭窄远端肠管管径正常。手术中也发现了类似的结果。狭窄肠段存在结肠系膜。切除的狭窄段在组织病理学检查中显示有足够的神经节细胞。