Megacolon

Megacolon - gigantism of the large intestine of various origins (Hirschsprung's disease, Chagas disease, idiopathic megacolon, etc.).

Etiology. Congenital maldevelopment or toxic damage to the nerve ganglia of the colon wall; Dystrophic processes in the central nervous system, causing violations of motor activity of the distal parts of the colon or its segments; Organic narrowing of the luminal gut. Difficult progress of fecal masses along the non-surplus or narrowed colon leads to a sharp expansion and hypertrophy of the wall of the above-mentioned divisions with subsequent decompensation of the motor function at this level. Slowing down the passage of intestinal contents, prolonged stagnation in the colon (stools are often absent for 5-7 days, and sometimes 30 days) cause intoxication, metabolic disturbances, delay in child development, or a sharp decrease in the ability to work when a megacolon occurs in adults (more often noted At the age of 20-30 years).

Symptoms, course. Prolonged constipation, abdominal enlargement, swollen loops of the large intestine swelling through the abdominal wall, general weakness, exhaustion, physical and mental underdevelopment (in children), a high predisposition to other diseases.

The diagnosis is based on the listed symptoms and the results of X-ray examination (in-patient). In adults, the megacolon develops slowly, often without significant symptoms, so at this stage of the disease, an X-ray examination (irrigoscopy) is crucial. To clarify the nature of the megacolon, a general clinical examination, a colonoscopy, a rectoanalysis reflex, an acetylcholinesterase test, and sometimes a deep (transanal) biopsy of the rectum wall are necessary.

Treatment. In the early stages, an attempt at conservative treatment (cleansing enemas, diet therapy, laxatives) is possible. With a pronounced clinical picture, surgical treatment in both children and adults, and with agangliosis (Hirschsprung's disease) it is necessary to remove the entire zone of agangliosis or hypoganglion. Subtotal resection of the large intestine is often required.

The prognosis depends on the form and cause of the megacolon, the correctness of the method and the volume of the operation.