Segmental Colonic Oligoganglionosis in Adult, Report of a Case Takashi Joh 1 , Makoto Itoh 1 , Kouhei Katsumi 1 , Yoshifumi Yokoyama 1 1The First Department of Internal Medicine, Nagoya City University, School of Medicine pp.1085-1090
Published Date 1987/9/25
DOI https://doi.org/10.11477/mf.1403113008
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 A 40 year-old man with no known history of difficulty in defecation in his childhood, visited our hospital complaining of periodic severe abdominal pain, abdominal distension and fever. Plain abdominal x-ray film showed marked dilatation of the ascending and transverse colon with fluid level formation. Barium enema examination revealed sigmoid and transverse colon to be poorly distended with marked dilatation proximal to it. The mucosal pattern was almost normal in the poorly distended segment while shallow and irregular ulcers were seen in the dilated transverse colon. These findings were also confirmed by colonoscopic examination.

 The patient was clinically diagnosed as having idiopathic long segmental narrowing of the colon with chronic obstruction. As ileus symptom was not relieved by conservative therapy, surgery was perfomed, which revealed neither mechanical obstruction nor abnormal findings in other abdominal viscera. Narrow part of the colon was resected. Histological examination revealed marked decrease in number of normal ganglion cells in both Auerbach's and Meissner's plexuses in the affected part of the resected specimen. In contrast, normal ganglion cells were found in the areas proximal and distal to the involved segment. Based on these histological findings, the final diagnosis of segmental colonic oligoganglionosis was made.

 The features of this case were that symptoms appeared for the first time in his forties, that the colon was involved segmentally and that oligoganglionosis was seen in both Auerbach's and Meissner's plexuses. This case seems to differ from classical Hirschsprung's disease in adult.

Copyright © 1987, Igaku-Shoin Ltd. All rights reserved.


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