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Case Report

Segmental Dilatation of the Sigmoid Colon: A Rare Cause of Chronic Constipation

Journal of the Korean Association of Pediatric Surgeons 1995;1(1):68-72.
Published online: June 30, 1995

Division of Pediatric Surgery, Department of Surgery, Keimyung University Dongsan Medical Center, Taegu, Korea.

1Division of Pediatric Surgery, Department of Pediatrics, Keimyung University Dongsan Medical Center, Taegu, Korea.

2Division of Pediatric Surgery, Department of Diagnostic Radiology, Keimyung University Dongsan Medical Center, Taegu, Korea.

3Division of Pediatric Surgery, Department of Pathology, Keimyung University Dongsan Medical Center, Taegu, Korea.

Copyright © Korean Association of Pediatric Surgeons

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  • Segmental dilatation of the colon is a very rare disease entity of unknown etiology and may mimic Hirschsprung's disease. It is characterized by dilatation of a segment of the colon of variable length with obstruction due to lack of peristalsis in a normally innervated intestine. Recently authors experienced a case of segmental dilatation of the sigmoid colon in a 6 month-old male, who presented with severe constipation, abdominal distention, and abdominal mass since 2 months of age. Down's syndrome and congenital nystagmus were associated. Barium enema demonstrated focal dilatation of the sigmoid colon, but the rectum and descending colon proximal to the affected colon were of normal caliber. Rectal suction biopsy with acetylcholinesterase staining was normal and anorectal manometry showed normal rectosphincteric reflex. At operation, there was a massively dilated and hypertrophied sigmoid colon with increased tortuous serosal vessels, measuring 15 cm in length and 10 cm in width. Teniae coli were identifiable in the affected segment. Frozen section biopsies at the proximal, affected, and distal colon showed ganglion cells. Descending loop colostomy was constructed initially and segmental resection and end to end colocolostomy were carried out 3 months later. Final histologic examination showed 1) normal colonic mucosa with ganglion cells, 2) prominent submucosal fibrosis and marked muscular hypertrophy, 3) unremarkable acetylcholinesterase activity and immunohistochemical findings against S-100 protein. On 8 months follow-up, he has been doing well and moves bowels 1-2 times daily.

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Segmental Dilatation of the Sigmoid Colon: A Rare Cause of Chronic Constipation
J Korean Assoc Pediatr Surg. 1995;1(1):68-72.   Published online June 30, 1995
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Segmental Dilatation of the Sigmoid Colon: A Rare Cause of Chronic Constipation
J Korean Assoc Pediatr Surg. 1995;1(1):68-72.   Published online June 30, 1995
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Segmental Dilatation of the Sigmoid Colon: A Rare Cause of Chronic Constipation
Segmental Dilatation of the Sigmoid Colon: A Rare Cause of Chronic Constipation