Abstract
IntroductionHirschsprung's disease (HD) is uncommon in adulthood. In this study, we describe the management of two cases of adult Hirschsprung's disease treated with transanal colonic pull-through procedure followed by a delayed coloanal anastomosis.Patients and methodsThis was a retrospective (December 2016 to Jun 2019) study included two cases of adult HD with confirmed Hirschsprung disease who underwent surgery at Zinder National hospital, Niger. The registration number is researchregistry 5174.ResultsThese were two patients aged 21 years (male) and 22 years (female) admitted to the emergency department with an acute bowel obstruction. The history finds a delayed passage of meconium at birth with a history of long-standing recurrent constipation since early childhood for the 2 patients. A lateral colostomy was performed urgently in both patients and the barium enema revealed a disparity of the sigmoid colon with corn shaped transition zone. Histologic examination of the biopsy specimen confirmed the diagnosis of HD. Surgery was done according to transanal endorectal pull-through procedure followed by delayed coloanal anastomosis. Patients were regularly followed over a period of 16 months. Constipation was gone, no continence problem was reported and quality of life was rated satisfactory.ConclusionThe discovery of Hirschsprung's disease is rare in adulthood. Transanal endorectal pull-through procedure followed by delayed coloanal anastomosis with conventional surgery is a suitable option for the treatment of HD and gives a good result.
Highlights
IntroductionWe describe the management of two cases of adult Hirschsprung's disease treated with transanal colonic pull-through procedure followed by a delayed coloanal anastomosis
Hirschsprung's disease (HD) is uncommon in adulthood
We report our experience in the management of two cases of adult Hirschsprung's disease treated by the rectosigmoid resection with a transanal colonic pullthrough procedure followed by a delayed coloanal anastomosis
Summary
We describe the management of two cases of adult Hirschsprung's disease treated with transanal colonic pull-through procedure followed by a delayed coloanal anastomosis. This rare disease (1/5000 live births) results to a permanent spasm of the aganglionic segment and leads to progressive dilation of the upstream colon [1,2,4] It is a condition traditionally diagnosed and treated in infancy, but diagnosis of HD in adulthood is rare [2,3]. We report our experience in the management of two cases of adult Hirschsprung's disease treated by the rectosigmoid resection with a transanal colonic pullthrough procedure followed by a delayed coloanal anastomosis
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