特発性慢性便秘症の１手術例

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  • A Case of Total Abdominal Colectomy for Idiopathic Chronic Constipation.

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This paper reports a case of idiopathic chronic constipation that underwent total abdominal colectomy with laparoscope. A 22-year-old female had severe constipation that was not effected by conservative treatment. There was no morphologic change in the colon and rectum. The function for rectal evacuation was adequate, although rectal compliance decreased and defecography showed secondary rectal function abnormality. The transit time study revealed an obviously slow transit pattern, hence total abdominal colectomy with ileorectal anastomosis was carried out. Postoperative bowel frequency was three or four stools per day, and then rectal function improved. Silver staining of the myenteric plexus showed reduced numbers of argyrophilic neurons significantly in comparison with 10 nonobstructive controls who undewent surgery for colon cancer. The fact that morphologically abnormal argyrophilic neurons of the total colon existed supported the necessity of total colectomy for slow transit constipation.

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