A Case of Idiopathic Megacolon Treated with Subtotal Colorectal Resection

Abstract

A 79-year-old man who had been prescribed laxatives with a diagnosis of atonic constipation over two years presented with worsening of constipation and appetite loss which began after hospitalization for femoral neck fracture. A CT scan revealed prominent dilatation of the colon from the ascending to the sigmoid colon, but no organic stricture was seen with a lower gastrointestinal endoscopy. Despite frequent deaeration treatments, his stomach bloating hardly improved and so he presented to our department. He was diagnosed with idiopathic megacolon and was discharged from our hospital after subtotal colorectal resection and ileostomy. Histopathology revealed a reduced number as well as a partial lack of ganglion cells in the intestinal wall of the dilated colon. Idiopathic megacolon is a rare entity and, to date, there is no clear notion of the therapeutic guidelines. We here present a case of idiopathic megacolon in which subtotal colorectal resection led to a favorable clinical course.