[Treatment of congenital aganglionic megacolon in adults]

The authors present 5 cases of congenital aganglionar megacolon in patients over 12 years of age. They were diagnosed and treated in the Digestive System Service and Surgery Department of the "Virgen del Rocío" University Hospital of Seville (Spain). After describing the infrequent incidence of this pathology outside early childhood, the different procedures proposed for its diagnosis are described. Once clinical suspicion of megacolon was established, a careful clinical history with special reference to bowel habit from birth was made, as well as a barium enema, anorectal manometry and rectal endoscopy and biopsy for histological and histochemical studies. Once diagnosed, all patients underwent surgery consisting in excision of the aganglionar colorectal segment, retrorectal lowering of the healthy colon and exteriorization through the fibers of the internal anal sphincter. A side-to-side transanal anastomosis between the healthy colon and diseased rectum (Duhamel II) was fashioned. All the patients had a satisfactory evolution with little immediate morbidity. Five to ten years after performing the operations, the patients remained asymptomatic, without bowel habit disturbances and showed an adequate development.