Urooj S*, Javaid H, Sheikh BA, Jabeen R and Siddiqui SZ
Department of Anesthesia, Dow University of Health Sciences, PakistanFulltext PDF
Background: Megacolon is defined as dilation of bowel loop >9 cm in width. Megacolon can be acute that is secondary to some obstruction or chronic which could be congenital (Hirschsprung’s disease), acquired (e.g. toxic megacolon secondary to gut inflammation) or idiopathic. Whatever the cause of mega colon is, it always presents as constipation and abdominal distension. Idiopathic mega colon is rare form of mega colon and the actual cause is unknown. Its prevalence is more in females and it can present at any age (childhood or adulthood). Diagnosis of idiopathic mega colon can be made with contrast enhanced computer tomography, barium swallow and tissue biopsy. Case Presentation: This is the case report of 16 years old girl who presented to A & E Department with ten days history of absolute constipation. She developed progressive abdominal distension with difficulty in breathing over 3 weeks. On further questioning, her past history revealed on and off [intermittent] constipation since 6 years which was relieved by laxatives and enema. Emergency laparotomy was planned under general anesthesia in view of grossly distended and painful abdomen with shortness of breath. Her chest X-ray revealed multiple gas shadows in thorax with upward displacement of diaphragm causing compression effects on her mediastinum. We managed this patient successfully peri-operatively. Conclusion: Adult idiopathic mega colon is a rare form of massive megacolon. In this case it compromised patient’s cardiovascular and respiratory system. There is need for research and education for anesthetic management of such cases so that morbidity and mortality can be decreased
Urooj S, Javaid H, Sheikh BA, Jabeen R, Siddiqui SZ. Successful Perioperative Management of Patient with Massive Megacolon. Ann Clin Case Rep. 2020; 5: 1880.