Megarectum
Updates to Case Attributes
Hirschsprung disease is the most common cause of neonatal colonic obstruction. It accounts for ~15-20% of all intestinal obstructions in the neonate. It can present later in life, as in this perceived case.
The main differential is a functional megarectum.
In this case, it only came to light due to the dutiful examination of a a maxillofacial surgeon, just prior to performing a mandibular resection for an ameloblastoma.
Retrospective questioning indicated the patient has not emptied her bowel for 3 months!
The patient/patient guardian declined rectal biopsy to confirm the strong suspicion of late presentation of Hirschsprung's disease.
-<p><a href="/articles/hirschsprung-disease"><strong>Hirschsprung disease</strong></a> is the most common cause of neonatal colonic obstruction. It accounts for ~15-20% of all intestinal obstructions in the neonate. It can present later in life, as in this perceived case.</p><p>The main differential is a functional megarectum.</p><p>In this case it only came to light due to the dutiful examination of a maxillofacial surgeon, just prior to performing a mandibular resection for an ameloblastoma.</p><p>Retrospective questioning indicated the patient has not emptied her bowel for 3 months!</p><p>The patient/patient guardian declined rectal biopsy to confirm the strong suspicion of late presentation Hirschsprung's disease.</p>- +<p><a href="/articles/hirschsprung-disease"><strong>Hirschsprung disease</strong></a> is the most common cause of neonatal colonic obstruction. It accounts for ~15-20% of all intestinal obstructions in the neonate. It can present later in life, as in this perceived case.</p><p>The main differential is a functional megarectum.</p><p>In this case, it only came to light due to the dutiful examination of a maxillofacial surgeon, just prior to performing a mandibular resection for ameloblastoma.</p><p>Retrospective questioning indicated the patient has not emptied her bowel for 3 months!</p><p>The patient/patient guardian declined rectal biopsy to confirm the strong suspicion of late presentation of Hirschsprung's disease.</p>
Updates to Study Attributes
The rectum to the rectosigmoid junction is massively distended measuring 11cm in axial diameter, and is occupied by a large volume of impacted faeces.
The bladder and uterus are displaced by the faeculantfeculent filled rectum.
No proximal bowel obstruction.
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