A case of severe megacolon due to acquired isolated hypoganglionosis after low anterior resection for lower rectal cancer

Tetsuro Tominaga, Satoshi Nagayama, Manabu Takamatsu, Shun Miyanari, Toshiya Nagasaki, Tomohiro Yamaguchi, Takashi Akiyoshi, Tsuyoshi Konishi, Yoshiya Fujimoto, Yosuke Fukunaga, Masashi Ueno

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

Acquired isolated hypoganglionosis is a rare intestinal neurological disease, which presents in adulthood with the clinical symptoms of chronic constipation. A 39-year-old man underwent laparoscopic low anterior resection and covering ileostomy for locally advanced-rectal cancer. A 6-month course of postoperative adjuvant chemotherapy was completed, followed by closure of the ileostoma. After the closure, he developed severe colitis which required 1-month of hospitalization. Mucosal erosions and pseudo-membrane formation were evident on colonoscopy and severe mucosal damage characterized by infiltration of inflammatory cells and crypt degeneration were pathologically confirmed. Even after the remission of the colitis, he suffered from severe constipation and distention. At 4 years after the stoma closure, he decided to undergo laparoscopic total colectomy. Histopathologically, the nerve fibers and ganglion cells became gradually scarcer from the non-dilated to dilated regions. Immunohistochemical staining examination confirmed that the ganglion cells gradually decreased and became degenerated from the normal to dilated region, thereby arriving at the final diagnosis of isolated hypoganglionosis. The patient recovered without any complications and there has been no evidence of any relapse of the symptoms. We present a case of acquired isolated hypoganglionosis-related megacolon, which required laparoscopic total colectomy, due to severe enterocolitis following stoma closure.

Original languageEnglish (US)
Pages (from-to)328-333
Number of pages6
JournalClinical Journal of Gastroenterology
Volume13
Issue number3
DOIs
StatePublished - Jun 1 2020
Externally publishedYes

Keywords

  • Acquired isolated hypoganglionosis
  • Laparoscopic total colectomy
  • Megacolon

ASJC Scopus subject areas

  • Gastroenterology

Fingerprint

Dive into the research topics of 'A case of severe megacolon due to acquired isolated hypoganglionosis after low anterior resection for lower rectal cancer'. Together they form a unique fingerprint.

Cite this