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KMID : 0371319770190020061
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Journal of the Korean Surgical Society
1977 Volume.19 No. 2 p.61 ~ p.70
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Surgical Management of Chronic Constipation
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安東皓/Ahn, Dong Ho
朴宇鉉/李仁/姜重信/Park, Woo Hyun/Lee, Inn/Kang, Joong Shin
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Abstract
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Constipation is defined as an abnormal retention of fecal matter and undue delay in discharge. Chronic constipation are due to primary disturbance of bowel function rather than to change secondary to organic diseases in the bowel or elsewhere. But orgenic disorder or congenital malformations are led to incontinence or constipation. Particularly, chronic type of constipation may be known as the condition resulting from insufficient frequency of defecation, deficient quantity of stool or production of abnormally hard and dry stools. Even if the interval is longer as every three to five days, easy passage of a soft stool may represent the normal event. Either colonic or rectal type of constipation may be resulted from organic disorders, including pelvic narrowing resulting from traumatic operative delivery or postoperative adhesion of the intestine may be required surgical repairs. At first we have to recognize normal process of defecation. Net forward velocity of the intestine is normally about 5.0 cm, per hour and ingestion of food doubles this rate. The sigmoid reservior collects the formed residue. When the rectum fills and becomes sufficiently distended, centers in the sacral part of the spinal cord facilitate defecation reflex which causes signioid peristalsis, increases pressure in the rectum, relaxes the internal sphincter and contracts the external anal sphincter. The resulting urge leads to relaxation of the external sphincter and contractions of diaphragmatic, abdominal, perianal and other muscles. Of course, constipation may result from the disturbance of these physiologic activities.
We report three cases of surgically repaired chronic and organic constipation which were due to an organic disorder of large bowel, and reviewed literatures.
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