[Congenital megacolon in adults]

Hirschsprung's disease is reported in 11 adults. About half of the patients had had previous surgery without relief of their symptoms. Diagnosis is established by a history of obstinate constipation since birth, the physical finding of abdominal distension and signs of large bowel obstruction without mechanical impediment. The definite diagnosis of Hirschsprung's disease rests on the demonstration of the absence of intramural ganglion cells in the rectum. The patients reported on underwent either the Rehbein-type operation or the Duhamel retrorectal pull-through. A three-stage procedure is recommended. Late results were satisfactory with both techniques provided there had been adequate resection of the aganglionic segment and anal dilatation to overcome the spasm of the internal anal sphincter.