Hirschsprung Disease Quick overview

Megacolon: Causes, Symptoms, Diagnosis, and Treatment

Megacolon is an abnormal dilation of the colon that is not caused by mechanical obstruction. It can be congenital or acquired. 

In this article, we will discuss the causes, symptoms, diagnosis, and treatment of megacolon.

Causes of Megacolon:

1. Congenital megacolon:

Hirschsprung disease is the most common cause of congenital megacolon. It is caused by defective migration of neural crest cells into the mesodermal layer of the gut. This results in aganglionosis, which is the absence of ganglions in a portion of the intestinal tract.

2. Acquired megacolon:

Acquired megacolon can be caused by poor bowel habits, drugs such as antipsychotics, and infections such as Chagas disease.

Symptoms of Megacolon:

The symptoms of megacolon vary depending on the underlying cause. However, some of the common symptoms are:

• Delayed passage of meconium

• Bilious vomiting

• Abdominal distension

• Enterocolitis with bloody stools and fever

• Perforation, constipation, and rectal bleeding are some of the complications that may 

   occur.

Diagnosis of Megacolon:

1. Rectal manometry:

 It is a useful screening procedure for megacolon. There is a failure of the internal anal sphincter to relax after dilatation of the rectum. An abnormal test is not absolutely diagnostic, but a normal test excludes the diagnosis.

2. Rectal biopsy: 

It is the definitive diagnostic procedure for megacolon. It shows the absence of ganglion cells and ganglia in the affected segment and thickening and hypertrophy of the nerve trunk.

3. Barium enema:

It shows a contracted aganglionic segment and dilatation of the normal proximal segment. Just distal to the dilated segment, there is a transitional zone that is partially dilated.

4. ACHE staining technique:

 It is a useful technique for the diagnosis of megacolon.

Treatment of Megacolon:

Surgical resection of the affected segment and anastomosis of normal segments is the treatment of choice for megacolon. The surgical options are Swenson, Duhamel, Soave, and Boley procedures. 

A diversion colostomy is done initially to gain time if the patient is not fit for surgery.

Conclusion:

Megacolon is an abnormal dilation of the colon that is not caused by mechanical obstruction. 

It can be congenital or acquired. Hirschsprung disease is the most common cause of congenital megacolon. 

The symptoms of megacolon vary depending on the underlying cause. 

Rectal biopsy is the definitive diagnostic procedure for megacolon. 

Surgical resection of the affected segment and anastomosis of normal segments is the treatment of choice.

FAQ

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Q-What are the markers for Hirschsprung disease?

Q-हिर्स्चस्प्रुंग रोग के लिए सबसे सटीक नैदानिक ​​परीक्षण क्या है?

Q-हिर्स्चस्प्रुंग रोग का मुख्य कारण क्या है?

Q-हिर्स्चस्प्रुंग रोग को जन्मजात मेगाकॉलन क्यों कहा जाता है?