2020 Volume 53 Issue 4 Pages 360-370
Hypoganglionosis (HG) is characterized by the decrease in the number of intestinal glia cells and categorized as allied Hirschsprung’s disease. Usually it is recognized as a pediatric disease. Adult cases are extremely rare and to the best of our knowledge, there have been no reported surgical cases for colon cancer with HG. Here, we describe a case of right hemicolectomy for ascending colon cancer with HG. The patient was a 54-year-old man who had positive fecal blood test results from a medical checkup. The colonoscopy revealed a type 2 tumor in the ascending colon. CT and esophagogastroduodenoscopy indicated an abnormally dilated duodenum, and barium enema showed the dilated colon without folds. A laparoscopic right hemicolectomy was performed for ascending colon cancer. The laparoscopic view indicated the dilated and relaxed intestine. In the postoperative course, he had recurrence of obstruction at the anastomotic site. Laparoscopic assisted ileo-transverse bypass improved the obstruction. The histopathological diagnosis was ascending colon cancer pT3N0M0 pStage II and HG. There was no recurrent obstruction after the second surgery therefore, we believe securing an adequate diameter of the anastomosis is significant.
