Subtotal colectomy with cecorectal anastomosis at the long segment, hirschprung’s disease – case reports

Congenital long segment megacolon is still a serious therapeutic problem. It is generally accepted that conservative treatment without surgical intervention will not give satisfactory results. The purpose of this case report is to show how subtotal colectomy and anastomosis cecorectalis is the operation of choice. At the Children’s Hospital in Zagreb we have had only two cases on which we performed cecorectal anastomosis. The patient’s general condition and enormous dilatation of the ganglionic region indicated surgery and only anus praeter bipollaris was performed on the colon ascendens. The second operation took place one year after the first operation. At the second operation we performed subtotal colectomy with cecorectal anastomosis. The postoperative clinical course was without complications. The wound cured regularly. Digitorectal examination revealed no anomalies in the anastomosis. The children had 1-2 stools daily. After six months we performed a check up examination with irigography, which displayed the regular filling of the rectum and the cecum with reflux in the terminal ileum without signs of stenosis. The general condition after surgery is very good. The children are growing and developing well and do not have constipation. No diet is necessary. The postoperative course , the patients’ condition and clinical tests showed that this form of treatment of congenital megacolon has been successful.