S상 결장 분절확장증

박우현; 최순옥; 백태원; 이희정; 서수지; 김상표

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자료유형: 학술저널

저자정보: 박우현 (계명대학교 동산병원 소아외과) 최순옥 (계명대학교 동산병원 소아외과) 백태원 (계명대학교 동산병원 소아과) 이희정 (계명대학교 동산병원 진단방사선과) 서수지 (계명대학교 동산병원 진단방사선과) 김상표 (계명대학교 동산병원 병리과)

저널정보: 대한소아외과학회 Journal of the Korean Association of Pediatric Surgeons : JKAPS Journal of the Korean Association of Pediatric Surgeons : JKAPS 제1권 제1호

발행연도: 1995.1

수록면: 68 - 72 (5page)

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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 t o 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.

#Segmental dilatation #Colon #Constipation

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