2020 Volume 73 Issue 4 Pages 157-162
Megacolon refers to the pathological enlargement of the large intestine without mechanical obstruction thereof. Here, we report a case of idiopathic chronic megacolon in which a bowel transit time test using a radiopaque marker was useful in determining the extent of colectomy.
The patient was a 67-year-old man. His past medical history included diabetes and mental illness. He visited a local clinic for vomiting and pain in the left lower abdomen, and a massive sigmoid colon compressing the diaphragm as well as fecal impaction were detected. After he was referred to and hospitalized in our hospital, he underwent defecation function tests, including a bowel transit time test, and gastrointestinal examinations while receiving conservative treatment. Although elective surgery was planned, he went into septic shock after disimpaction; thus, the scheduled Hartmann operation was performed. The postoperative course was uneventful with no requirement for laxatives.
The bowel transit time test can determine the presence or absence of small intestinal dysfunction depending on the marker distribution. This may useful in determining the extent of the intestinal tract that should be resected.
