Colonic stricture complicating degenerative leiomyopathy. A case report.

Area of Science:

• Gastroenterology
• Colorectal Surgery
• Medical Genetics

Background:

• Degenerative leiomyopathy can cause massive megacolon, a condition known as pseudo-Hirschsprung's disease in Black individuals.
• Colonic strictures are a known complication of inflammatory bowel disease but are rarely associated with pseudo-Hirschsprung's disease.
• Acute large-bowel obstruction presents a surgical emergency requiring prompt diagnosis and management.

Purpose of the Study:

• To report a unique case of acute large-bowel obstruction secondary to colonic stricture in a patient with pseudo-Hirschsprung's disease.
• To highlight the successful surgical management of this rare complication.
• To add to the literature the first reported instance of organic colonic stricture complicating pseudo-Hirschsprung's disease in Black individuals.

Main Methods:

• A case study approach was used, detailing the clinical presentation, diagnostic workup, and surgical intervention.
• The patient underwent colonic resection and end-to-end anastomosis for the management of the obstruction.
• Postoperative outcomes and follow-up were documented.

Main Results:

• The patient presented with acute large-bowel obstruction.
• A colonic stricture was identified as the cause of the obstruction in the setting of massive megacolon (pseudo-Hirschsprung's disease).
• Successful surgical management was achieved through colonic resection and end-to-end anastomosis, with a favorable postoperative course.

Conclusions:

• Organic colonic stricture is a previously unreported complication of pseudo-Hirschsprung's disease in Black individuals.
• Prompt surgical intervention, including resection and anastomosis, can effectively manage acute large-bowel obstruction in such cases.
• This case expands the understanding of potential complications associated with pseudo-Hirschsprung's disease.