Abstract |
A rare case of a severely constipated patient with rectal aganglionosis is herein reported. The patient, who had no megacolon/megarectum, underwent a STARR, i.e., stapled transanal rectal resection, for obstructed defecation, but her symptoms were not relieved. She started suffering from severe chronic proctalgia possibly due to peri-retained staples fibrosis. Intestinal transit times were normal and no megarectum/ megacolon was found at barium enema. A diverting sigmoidostomy was then carried out, which was complicated by an early parastomal hernia, which affected stoma emptying. She also had a severe diverting proctitis, causing rectal bleeding, and still complained of both proctalgia and tenesmus. A deep rectal biopsy under anesthesia showed no ganglia in the rectum, whereas ganglia were present and normal in the sigmoid at the stoma site. As she refused a Duhamel procedure, an intersphincteric rectal resection and a refashioning of the stoma was scheduled. This case report shows that a complete assessment of the potential causes of constipation should be carried out prior to any surgical procedure.
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Authors | Lorenzo C Pescatori, Vincenzo Villanacci, Mario Pescatori |
Journal | World journal of gastroenterology
(World J Gastroenterol)
Vol. 20
Issue 15
Pg. 4462-6
(Apr 21 2014)
ISSN: 2219-2840 [Electronic] United States |
PMID | 24764689
(Publication Type: Case Reports, Journal Article)
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Chemical References |
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Topics |
- Barium
(chemistry)
- Biopsy
- Constipation
(surgery)
- Defecation
- Digestive System Surgical Procedures
(adverse effects)
- Enema
- Female
- Fibrosis
- Hernia
(complications, pathology)
- Hirschsprung Disease
(surgery)
- Humans
- Megacolon
(surgery)
- Middle Aged
- Recurrence
- Surgical Stapling
(adverse effects)
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