-Case Reports-

Segmental Hypoganglionosis of the Colon: A Case Report

Aya Yamagishi¹, Nobuatsu Koyama¹, Naoyuki Yamashita¹, Mikito Suzuki¹, Takeshi Yamada², Manpei Kawashima² and Hiroshi Yoshida²

¹Department of Surgery, Tsuboi Hospital, Koriyama City, Japan
²Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Nippon Medical School, Tokyo, Japan

A 64-year-old woman was admitted to hospital with persistent abdominal pain. She had been hospitalized with similar symptoms on five occasions during a period of 2 years. Computed tomography revealed dilatation and fecal impaction from the ileum to the transverse colon. A barium enema and simultaneous ileus tube radiography showed a narrow segment of descending-sigmoid colon. Colonoscopy showed no mucosal change. Her symptoms did not improve with conservative therapy, so descending and sigmoid colectomy was performed. Histologic examination showed disappearance of ganglion cells; axon of Meissner's plexuses was present, and the number of Auerbach's plexuses was decreased. The definitive diagnosis was segmental hypoganglionosis (SH) of the colon. The postoperative course was uneventful, and the functional result was positive at 1 year postoperatively. SH is extremely rare; however, surgical intervention is expected to be of benefit. Therefore, it is important to keep SH in mind when treating patients with chronic obstruction of the left side of the colon.

J Nippon Med Sch 2021; 88: 370-374

Keywords
colectomy, colon, dilatation

Correspondence to
Aya Yamagishi, MD, PhD, Department of Surgery, Tsuboi Hospital, 1-10-13 Nagakubo, Asakamachi, Koriyama City, Fukushima 963-0197, Japan
ayatani@nms.ac.jp

Received, June 2, 2020
Accepted, September 11, 2020