A Pediatric Patient With Severe Chronic Constipation Successfully Treated by Rectosigmoid Resection

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  • Saito Eriko
    Department of Pediatric Surgery, Chiba Children’s Hospital Department of Pediatric Surgery, Matsudo City Hospital Children’s Medical Center
  • Higashimoto Yasuyuki
    Department of Pediatric Surgery, Chiba Children’s Hospital
  • Sato Yoshiharu
    Department of Pediatric Surgery, Chiba Children’s Hospital
  • Terui Keita
    Department of Pediatric Surgery, Chiba Children’s Hospital
  • Ohashi Kensuke
    Department of Pediatric Surgery, Chiba Children’s Hospital
  • Iwai Jun
    Department of Pediatric Surgery, Chiba Children’s Hospital

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Other Title
  • 拡張腸管切除術が有用であった小児重症慢性機能性便秘症の1例
  • 症例報告 拡張腸管切除術が有用であった小児重症慢性機能性便秘症の1例
  • ショウレイ ホウコク カクチョウ チョウカン セツジョジュツ ガ ユウヨウ デ アッタ ショウニ ジュウショウ マンセイ キノウセイ ベンピショウ ノ 1レイ

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Abstract

A 9-year-old boy had been suffering from severe constipation with soiling and incontinence since he was an infant. Contrast enema demonstrated an enormously dilated rectosigmoid caused by fecal impaction. After fecal disimpaction under general anesthesia, rectal biopsy was performed and Hirschsprung’s disease and other organic diseases were ruled out. Although we considered that long-term management with laxatives and enemas was necessary to improve the patient’s condition, this treatment was practically difficult because of his family background problem and his psychological trauma from enemas. Ultimately, surgery was considered partly because of his family’s request. We resected the dilated rectosigmoid colon and performed stapled colorectal anastomosis. His postoperative course was good, and not only his defecation condition but also his quality of life was significantly improved. Two years after the surgery, medication was discontinued and constipation did not recur thereafter. After appropriate consideration of the operative indication and surgical procedure, a satisfactory functional outcome can be achieved in some patients with severe constipation.

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