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KMID : 0371320020630050403
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Journal of the Korean Surgical Society
2002 Volume.63 No. 5 p.403 ~ p.408
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Proper Treatment for Megacolon after Various Anoplasties for Anorectal Malformation
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Han Ai-Ri
Ko Yong-Taek
Oh Jung-Tak
Han Seok-Joo
Choi Seung-Hoon
Hwang Eui-Ho
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Abstract
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Purpose: The megacolon after repairing an anorectal malformation is not a rare complication, and there is much controversiy on the causes, the treatment of choice and the results after a longterm follow-up. We present 5 cases of a megacolon
after
the repair of an anorectal malformation, which were controlled with either a surgical resection or conservative treatment.
Methods: Five patients with a megacolon after the repair of an anorectal malformation were studied. A retrospective chart review was done and fecal continence was evaluated with an individual interview.
Results: All five patients initially underwent conservative treatment with laxatives and/or enemas. One Patient responded well to conservative treatment and the diameter of the bowel reduced to normal size. Another patient responded to
conservative treatment after correcting the location of the anus. Three patients needed a surgical resection and one of those needed a further procedure to correct the anal location. After the surgical resection of the megacolon and/or correction
of the
anus (one out of the three patients), they soon reported an almost normal bowel habit.
Coneclusion: The first step in treating a megacolon after repairing an anorectal malformation was conservative treatment. However patients without an adequate response to conservative treatment are best managed with a surgical resection.
The
cause of the megacolon is now under investigation and the lack of adequate management after repair is one of the subjects.
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