J Korean Assoc Pediatr Surg.  2013 Dec;19(2):156-161. 10.13029/jkaps.2013.19.2.156.

Laparoscopic-Assisted Transanal Endorectal Pull-Through for Segmental Dilatation of Rectosigmoid Colon in a Child

• Park JY
• Park J

• KMID: 1961507
• DOI: http://doi.org/10.13029/jkaps.2013.19.2.156

Abstract

Congenital segmental dilatation of the colon is a very rare entity of unknown etiology, characterized by a localized dilatation of a bowel segment of the colon of variable length and an abrupt transition between the normal and dilated intestine. It can affect any part of the colon, with the rectosigmoid colon being the most commonly affected site. The clinical and radiological features may resemble that of Hirschsprung disease, but differ in that the normal ganglion cells are found in the dilated and normal segment of the colon. We performed laparoscopic-assisted transanal endorectal pull-through for segmental dilatation of rectosigmoid colon in an 8-year-old boy with chronic constipation since the age of 5 months.

Keyword

Segmental dilatation; Rectosigmoid; Child

MeSH Terms

Child*
Colon*
Constipation
Dilatation*
Ganglion Cysts
Hirschsprung Disease
Humans
Intestines
Male

Figure

• 

  Fig. 1 Barium enema shows dilated rectosigmoid colon with abrupt transition to a normal proximal colon.

• 

  Fig. 2 Intraoperative photograph shows a localized dilatation of the rectosigmoid colon with normal colon proximally. Note also the dilated and tortuous mesocolic and serosal blood vessels.

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  Fig. 3 Microscopic examination shows marked hypertrophy of the inner circular muscle layer and abnormal location of ganglion cells (oblique arrows) within the inner circular muscle layer (H & E, × 20).

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