Abstract

This case report describes a rare occurrence of Hirschsprung's disease presenting in a 26-year-old pregnant woman from a rural area in Indonesia. Initially asymptomatic for pregnancy-related issues, the patient had experienced lifelong constipation, frequently managed with laxatives, and had significant abdominal distension. At approximately 34-35 weeks of gestation, an ultrasound during a routine obstetric check-up revealed intestinal dilation potentially compressing the uterus. Subsequent referral to a regional hospital confirmed the diagnosis of Hirschsprung's disease, differentiated from teratoma through imaging and postoperative findings. A classical caesarean section was performed at 38 weeks, during which a significantly dilated sigmoid megacolon and fecaloma were discovered and managed with a distal colostomy. This case highlights the challenges of diagnosing and managing rare gastrointestinal disorders in pregnant patients, emphasizing the importance of considering congenital anomalies in differential diagnoses to ensure appropriate prenatal care and surgical intervention.

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