巨大結腸症をきたしたｃｏｌｏｎｉｃ　ｉｎｅｒｔｉａの１例

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  • A CASE OF COLONIC INERTIA CAUSING IDIOPATHIC MEGACOLON

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A 37-year-old man with slight mental detardation who had been medically treated for constipation since 30 years of age became to have abdominal distention and was diagnosed as having megacolon elsewhere. The patient was referred to the hospital for close exploration and treatment. An anorectal manometric study revealed no abnormal findings, and the anorectal reflex was normal. A possibility of hypothyroidism or porphyria was ruled out based on hematological examinations. Mental and neurotic disorders were denied as well. Defecography showed no impairment of defecation function. On transit time study, a delayed transit time of more than 96 hours was noted, and colonic inertia was diagnosed. At surgery, an excision of subtotal colon and rectum and an ileo-rectal anastomosis (IRA) right over the Douglass' pouch were performed. As of 3 months after the operation, he has bowel movements three times a day and no constipation has recurred.

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