Total proctocolectomy and ileal J-pouch anal anastomosis for chagasic megacolon with fecaloma: report of a case.
Megacolon, resulting in severe constipation, is one of the most common manifestations of Chagas' disease. We herein report a case of megacolon with fecaloma in a 39-year-old Brazilian man who presented with severe constipation. He underwent a total proctocolectomy and ileal J-pouch anal anastomosis. Histologically, there was a marked thickening of the proper muscle layer, and a moderate decrease in the myoenteric nerve plexuses and neurons in the megacolon area. A feasible outcome has been achieved after a 1-year follow-up. A total proctocolectomy with ileal J-pouch anal anastomosis may therefore be one of the useful strategies for the surgical treatment of patients with chagasic megacolon.
Department of Gastrointestinal and Pediatric Surgery, Mie University Graduate School of Medicine, Edobashi 2-174, Tsu, Mie, 514-8507, Japan.
Toshimitsu
T
Araki
Chikao
C
Miki
Shigeyuki
S
Yoshiyama
Yuji
Y
Toiyama
Naoko
N
Sakamoto
Masato
M
Kusunoki
D001003:Anal Canal / Q000601:surgery*; D000714:Anastomosis, Surgical / Q000379:methods*; D014355:Chagas Disease / Q000150:complications*; D039021:Colonic Pouches; D005244:Fecal Impaction / Q000209:etiology; D008531:Megacolon / Q000209:etiology / Q000601:surgery*; D016737:Proctocolectomy, Restorative