1. Results of the Duhamel operation in the treatment of idiopathic megarectum and megacolon
- Author
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Stabile, G., Kamm, M.A., Hawley, P.R., and Lennard-Jones, J.E.
- Subjects
Colon (Anatomy) ,Megacolon ,Rectum -- Abnormalities ,Health - Abstract
Patients with idiopathic megarectum (extreme dilatation of the rectum of unknown cause) with or without megacolon (extreme dilation of the colon) may develop symptoms in childhood or adulthood. The major symptoms are abdominal pain, constipation, soiling, and recurrent fecal impaction. Usually medical treatment is successful, but some patients may require surgery. The Duhamel operation, originally developed to treat megacolon that occurs in Hirschsprung's disease, removes the upper rectum and dilated colon, and reconnects the remaining normal segment of bowel at the upper end of the anal canal. A report is presented of the outcome of 20 patients with megarectum and megacolon who underwent the Duhamel operation. Patients were treated over a 17-year period by one surgeon, and there were 14 males and six females. The average age of onset of constipation was three years; the average age at the time of surgery was 25 years. There were many complications soon after surgery; five patients required further surgery for constipation. Most patients had a subjective feeling of improved well-being after surgery, however, soiling, straining, abdominal pain, and distention were common after surgery. Ten patients had improvement in bowel frequency. Given these mixed results, it is recommended that patients with moderately dilated rectum or colon who require surgery undergo colectomy with ileorectal anastomosis. The Duhamel operation should be considered for patients with grossly dilated rectum and distal colon. (Consumer Summary produced by Reliance Medical Information, Inc.)
- Published
- 1991