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Related Experiment Videos

The hypertonic rectosigmoid junction: description of a new clinicopathologic entity causing constipation

A Shafik1

  • 1Department of Surgery and Experimental Research, Faculty of Medicine, Cairo University, Egypt.

Surgical Laparoscopy & Endoscopy
|April 1, 1997
PubMed
Summary

Rectosigmoid sphincter (RSS) achalasia, a condition causing chronic constipation, involves an aganglionic rectosigmoid sphincter. Treatment through dilatation or surgery resolved constipation in all eight patients studied.

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Area of Science:

  • Gastroenterology
  • Colorectal Surgery
  • Physiology

Background:

  • A rectosigmoid sphincter (RSS) regulates rectal and sigmoid colon activity.
  • Hypertonia of the RSS can lead to chronic constipation.
  • This condition, termed RSS achalasia, is characterized by absent nerve cells in the RSS.

Purpose of the Study:

  • To present cases of rectosigmoid sphincter (RSS) hypertonia.
  • To investigate the clinicopathologic features of RSS achalasia.
  • To evaluate treatment outcomes for patients with RSS achalasia.

Main Methods:

  • Anorectal manometry to assess RSS pressure and reflexes.
  • Intestinal transit studies to evaluate colonic function.
  • Histologic examination of RSS biopsies for aganglionosis.

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Main Results:

  • Eight patients with chronic constipation presented with elevated RSS resting pressure and absent sigmoidorectal reflexes.
  • Biopsies confirmed aganglionosis of the RSS, leading to a diagnosis of RSS achalasia.
  • Five patients improved with RSS dilatation; three underwent sigmoidomyotomy, with all patients remaining symptom-free.

Conclusions:

  • Rectosigmoid junction achalasia is a distinct clinicopathologic entity.
  • This condition should be considered in the differential diagnosis of chronic constipation.
  • Both RSS dilatation and sigmoidomyotomy are effective treatments for RSS achalasia.