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Chirurg 2021 Feb 25. Epub 2021 Feb 25.

Abteilung für Allgemein und Viszeralchirurgie, BG Klinikum Hamburg, Hamburg, Deutschland.

Background: Patients with paraplegia develop syndrome-specific complications relevant to visceral surgery, which occur in the context of the acute spinal shock or as a consequence of the progressive neurogenic bowel dysfunction (NBD) with the formation of an elongated colon and/or megacolon. Moreover, acute abdominal emergencies, such as acute appendicitis, cholecystitis, diverticulitis and ileus images, pose particular challenges for the clinician when the clinical signs are atypical or even absent. The expansion of indications for obesity surgery to include patients with a paraplegic syndrome, whose independence and quality of life can be impaired due to the restricted mobility, especially by obesity, is becoming increasingly more important. Read More

Case Rep Surg 2021 25;2021:8820724. Epub 2021 Jan 25.

Cairns Base Hospital, Australia.

Background: Chronic megacolon is a rare condition which primarily occurs in patients with autonomic dysfunction of a variety of causes. Its management is often challenging and people with chronic megacolon often suffer from abdominal distension, pain, and malabsorption. Given the struggles clinicians experience in managing these patients long term, this case study provides an example of an alternate strategy for the symptomatic management of chronic megacolon. Read More

PLoS One 2021 9;16(2):e0246692. Epub 2021 Feb 9.

Department of Bioscience and Technology, Institute of Tropical Pathology and Public Health, Federal University of Goias, Goiania, GO, Brazil.

Megacolon is one of the main late complications of Chagas disease, affecting approximately 10% of symptomatic patients. However, studies are needed to understand the mechanisms involved in the progression of this condition. During infection by Trypanosoma cruzi (T. Read More

Sci Rep 2021 Feb 4;11(1):3191. Epub 2021 Feb 4.

Biomedical Research Center, Chiba University, Chiba, Japan.

The Kif26a protein-coding gene has been identified as a negative regulator of the GDNF-Ret signaling pathway in enteric neurons. The aim of this study was to investigate the influence of genetic background on the phenotype of Kif26a-deficient (KO, -/-) mice. KO mice with both C57BL/6 and BALB/c genetic backgrounds were established. Read More

Clin J Gastroenterol 2021 Apr 17;14(2):621-625. Epub 2021 Jan 17.

Department of Gastrointestinal Hepato-Biliary-Pancreatic Surgery, Nippon Medical School, Tokyo, Japan.

Diaphragmatic eventration in an adult patient is a rare condition. We describe a case of an elderly patient with hemidiaphragm dysfunction caused due to chronic constipation. A 67-year-old woman with a medical history of descending colon cancer that was treated 24 years before undergoing partial colectomy was admitted to our hospital with complaints of progressive shortness of breath and dyspnea on exertion for the past few months. Read More

Histochem Cell Biol 2021 Apr 6;155(4):451-462. Epub 2021 Jan 6.

Department of Anatomy & Neuroscience, University of Melbourne, Parkville, Victoria, 3010, Australia.

Chagas disease is caused by the parasite, Trypanosoma cruzi that causes chronic cardiac and digestive dysfunction. Megacolon, an irreversible dilation of the left colon, is the main feature of the gastrointestinal form of Chagas disease. Patients have severe constipation, a consequence of enteric neuron degeneration associated with chronic inflammation. Read More

BMJ Case Rep 2020 Dec 22;13(12). Epub 2020 Dec 22.

General Surgery, Dudley Group NHS Foundation Trust, Dudley, UK

Cholecystocolonic fistula with associated idiopathic megabowel (megacolon and megarectum) is a rare presentation as acute large bowel obstruction. Frequently presenting with chronic constipation, acute bowel obstruction is rarely encountered in the presence of concomitant cholecystocolonic fistula. This presents diagnostic and management difficulties with no consensus on appropriate surgical approach. Read More

Front Cell Infect Microbiol 2020 15;10:583899. Epub 2020 Oct 15.

Departament of Pathology, Federal University of Minas Gerais, Belo Horizonte, Brazil.

There is a growing consensus that the balance between the persistence of infection and the host immune response is crucial for chronification of Chagas heart disease. Extrapolation for chagasic megacolon is hampered because research in humans and animal models that reproduce intestinal pathology is lacking. The parasite-host relationship and its consequence to the disease are not well-known. Read More

Afr J Paediatr Surg 2020 Jan-Jun;17(1-2):15-17

Department of Anaesthesiology, CM Hospital and Associated Medical College, Bhilai, Chhattishgarh, India.

Introduction: Diagnosis of Hirschsprung's disease depends on rectal biopsy. This study was designed to find an alternate diagnostic modality to exclude Hirschsprung's disease.

Aim: The aim of this study was to find the predictive value of delayed retention of contrast in excluding Hirschsprung's disease. Read More

Dig Liver Dis 2021 Apr 10;53(4):403-408. Epub 2020 Oct 10.

Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy; Division of Colon and Rectal Surgery, Humanitas Clinical and Research Hospital IRCCS, Rozzano, Milan, Italy. Electronic address:

Ulcerative colitis, a chronic inflammatory condition that affects the colon from rectum to caecum, is characterized by periods of increased bowel movements, blood in feces, rectal urgency, tenesmus, and abdominal pain, with periods of remission and flares of disease, which negatively impact quality of life. A number of therapeutic options are available for patients with moderate-to-severe ulcerative colitis, however, no clear treatment algorithm exists. Therapeutic goals include short-term benefits for patients (i. Read More

Mol Genet Genomic Med 2020 12 13;8(12):e1528. Epub 2020 Oct 13.

Centre for Molecular Medicine and Biobanking, Faculty of Medicine and Surgery, University of Malta, Msida, Malta.

Background: Mutations in the PHOX2B gene cause congenital central hypoventilation syndrome (CCHS), a rare autonomic nervous system dysfunction disorder characterized by a decreased ventilatory response to hypercapnia. Affected subjects develop alveolar hypoventilation requiring ventilatory support particularly during the non-REM phase of sleep. In more severe cases, hypoventilation may extend into wakefulness. Read More

J Surg Case Rep 2020 Sep 30;2020(9):rjaa320. Epub 2020 Sep 30.

Medical Research, Universidad Francisco Marroquín, Guatemala, Guatemala.

Hirschsprung disease (HSCR) is characterized by the absence of neuronal ganglion cells in a distal portion of the intestinal tract [1]. In 1691, Frederick Ruysch described the disease as congenital megacolon. HSCR-associated congenital anomalies have been reported in 5-32% of affected patients [2]. Read More

Anesth Prog 2020 09;67(3):158-163

Department of Anesthesiology, Kanagawa Dental University Hospital, Yokosuka, Kanagawa, Japan.

Inflammatory bowel disease (IBD) is a group of chronic inflammatory disorders of the gastrointestinal tract including ulcerative colitis (UC) and Crohn's disease. Pain management can be challenging in patients with IBD because there are limitations on the use of analgesics. Use of nonsteroidal anti-inflammatory drugs is not recommended in patients with IBD because there is risk of relapse of IBD and an overall increase in disease activity. Read More

Eur J Pediatr Surg 2020 Oct 28;30(5):413-419. Epub 2020 Sep 28.

Department of Pediatric Surgery, Children's National Medical Center, Washington, District of Columbia, United States.

Chronic idiopathic constipation, also known as functional constipation, is defined as difficult and infrequent defecation without an identifiable organic cause. Medical management with laxatives is effective for the majority of constipated children. However there is a subset of patients who may need evaluation by a surgeon. Read More

Radiol Case Rep 2020 Oct 11;15(10):1858-1863. Epub 2020 Aug 11.

Department of Neuroradiology, "Umberto I" Hospital, Viale San Francesco 2, 84014 Nocera Inferiore, Italy.

Currarino syndrome is a rare congenital disorder characterized by the triad of anorectal anomalies, sacrococcygeal dysgenesis and presacral mass. Because of the anorectal anomalies, the extrinsic compression due to the presacral mass and neurologic deficits, patients usually present with gastrointestinal symptoms, most commonly chronic constipation. Most cases of Currarino syndromes are diagnosed in childhood, at birth or in the pre-birth period and, even if adult presentation has been reported in few sporadic case reports, the diagnosis in the late stages of life remains extremely rare. Read More

Z Gastroenterol 2020 Aug 12;58(8):778-784. Epub 2020 Aug 12.

Klinik für Innere Medizin IV (Gastroenterologie, Hepatologie und Infektiologie), Universitätsklinikum Jena, Friedrich-Schiller-Universität Jena, Deutschland.

infections (CDI) are typical antibiotic therapy associated complications. Notwithstanding the fact that the clinical picture of may extend to the development of a toxic megacolon with potentially life-threatening sequelae, mild infectious forms associated with uncomplicated diarrhoea are by far the most prevalent and should also be treated according to clear clinical practice guidelines. However, there are currently conflicting international guidelines governing metronidazole-based treatment of mild infections. Read More

SAGE Open Med Case Rep 2020 22;8:2050313X20945531. Epub 2020 Jul 22.

Department of Pathology, Loma Linda University Medical Center, Loma Linda, CA, USA.

A 61-year-old alcoholic male with history of cholecystectomy presented with a 20-year history of recurrent bowel obstruction and a 30 lb weight loss. After numerous attempts at conservative management, exploratory laparotomy was performed, which showed no mechanical cause. Despite no clear etiology, the obstruction persisted and intensified. Read More

PLoS One 2020 17;15(7):e0235985. Epub 2020 Jul 17.

Department of Human and Animal Physiology, Institute of Fundamental Medicine and Biology, Kazan Federal University, Kazan, Republic of Tatarstan, Russian Federation.

Chronic constipation (CC) is one of the most common gastrointestinal disorders worldwide. Its pathogenesis, however, remains largely unclear. The purpose of the present work was to gain an insight into the role of contractility and microbiota in the etiology of CC. Read More

Ann Pediatr Endocrinol Metab 2020 Jun 30;25(2):112-117. Epub 2020 Jun 30.

Department of Pediatrics, Asan Medical Center Children's Hospital, University of Ulsan College of Medicine, Seoul, Korea.

Purpose: Oral supplementation of vitamin D can be inefficient in patients with vitamin D deficiency caused by intestinal malabsorption. This study investigated the efficacy and safety of parenteral vitamin D supplementation in infants and children with vitamin D deficiency caused by intestinal malabsorption.

Methods: This study included 11 patients with vitamin D deficiency who were unresponsive to oral vitamin D or were unable to try oral vitamin D therapy due to underlying conditions. Read More

Case Rep Gastroenterol 2020 Jan-Apr;14(1):220-225. Epub 2020 Apr 27.

Department of Clinical Pediatrics, Manima Not-for-Profit Healthcare and Assistance, Milan, Italy.

Constipation is frequent amongst infants who have undergone surgery for anorectal malformation (ARM). Faecal retention, due to a dysfunctional enteric reflex of defaecation, can cause abdominal cramps, pseudoincontinence and, in the worst cases, megacolon. Prokinetic protocols are used to stimulate at least 1 bowel movement per day, including laxatives, enema, stools softeners and dietary schedules. Read More

BMJ Open 2020 04 14;10(4):e033916. Epub 2020 Apr 14.

Discipline of Paediatrics, School of Women's and Children's Health, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia

Introduction: Chronic gastrointestinal and respiratory conditions of childhood can have long-lasting physical, psychosocial and economic effects on children and their families. Alterations in diet and intestinal and respiratory microbiomes may have important implications for physical and psychosocial health. Diet influences the intestinal microbiome and should be considered when exploring disease-specific alterations. Read More

World J Surg 2020 07;44(7):2426-2439

Department of Pediatric Surgery, Seoul National University College of Medicine, Seoul, Korea.

Background: Frequent stooling immediately after pull-through (PT), fecal soiling, and constipation are chronic complications of Hirschsprung's disease (HD). This study aimed to investigate the longitudinal outcomes in terms of bowel function of patients below the age of 1 year undergoing PT.

Methods: We retrospectively evaluated 396 patients who underwent PT for HD between September 1979 and March 2014. Read More

Clin J Gastroenterol 2020 Jun 11;13(3):328-333. Epub 2019 Dec 11.

Department of Gastroenterological Surgery, Gastroenterological Cancer, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan.

Acquired isolated hypoganglionosis is a rare intestinal neurological disease, which presents in adulthood with the clinical symptoms of chronic constipation. A 39-year-old man underwent laparoscopic low anterior resection and covering ileostomy for locally advanced-rectal cancer. A 6-month course of postoperative adjuvant chemotherapy was completed, followed by closure of the ileostoma. Read More

Am J Gastroenterol 2019 12;114(12):1847-1856

Division of Gastroenterology and Hepatology, Clinical Enteric Neuroscience Translational and Epidemiological Research (C.E.N.T.E.R.), Mayo Clinic, Rochester, Minnesota, USA.

Objectives: Although systemic sclerosis (SSc) is known to affect the gastrointestinal (GI) tract, most of the literature focuses on esophageal, small intestinal, or anorectal manifestations. There have been no reviews focused on large bowel SSc complications in over 30 years. The aim of this study is to perform a systematic review of colonic manifestations and complications of SSc. Read More

Pediatr Dev Pathol 2020 Jan-Feb;23(1):40-59. Epub 2019 Nov 21.

Department of Gastroenterology, Seattle Children's Hospital, University of Washington, Seattle, Washington.

Some patients continue to have obstructive symptoms and/or incontinence after pullthrough surgery for Hirschsprung disease. Incontinence can be due to injury to the anal sphincter and/or dentate line, abnormal colonic motility (nonretentive), or a chronic large stool burden (retentive). A diagnostic algorithm based on clinical and pathological evaluations can be applied to distinguish potential etiologies for obstructive symptoms, which segregate into anatomic (mechanical or histopathological) or physiologic subgroups. Read More

Transplant Proc 2019 Nov;51(9):3181-3185

Gastroenterology, Hepatology and Nutrition, Children's Hospital Los Angeles, University of Southern California Keck School of Medicine, Los Angeles, California. Electronic address:

Small intestinal transplantation is performed for patients with intestinal failure who failed other surgical and medical treatment. It carries notable risks, including, but not limited to, acute and chronic cellular rejection and graft malfunction. Late severe acute intestinal allograft rejection is associated with increased risk of morbidity and mortality and, in the majority of cases, ends with total enterectomy. Read More

Pediatr Surg Int 2020 Jan 31;36(1):11-19. Epub 2019 Oct 31.

Surgical Research Group, Murdoch Children's Research Institute, Melbourne, Australia.

Children with chronic idiopathic constipation (CIC) often end up at the surgeon when medical treatments have failed. This opinion piece discusses a recently described pattern of CIC called 'Rapid transit constipation (RTC)' first identified in 2011 as part of surgical workup. RTC was identified using a nuclear medicine gastrointestinal transit study (NMGIT or nuclear transit study) to determine the site of slowing within the bowel and to inform surgical treatment. Read More

Cir Pediatr 2019 Oct 1;32(4):195-200. Epub 2019 Oct 1.

Hospital Universitario y Politécnico La Fe. Valencia.

Objective: Retrospective and descriptive study of patients with diagnosis of Hirschsprung disease (HD) in whom transanal pull-through was performed in our center.

Material And Methods: All patients with diagnosis of HD in whom transanal surgery was performed between 2006 and 2018 in our center were selected. In all cases laparoscopic biopsy was performed in the previous dilated area. Read More

Epidemiol Infect 2019 10 14;147:e289. Epub 2019 Oct 14.

Division of Nephrology, Department of Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea.

The risk of metronidazole treatment failure in Clostridium difficile infection (CDI) patients with chronic kidney disease (CKD) or end-stage renal disease in Korea has not been established. We evaluated 481 patients who had been admitted to two secondary hospitals with a diagnosis of, and treatment for, CDI during 2010-2016. CDI patients were divided into three groups according to CKD status: non-CKD (n = 363), CKD (n = 55) and those requiring dialysis (n = 63). Read More

Cir Cir 2019 ;87(5):568-571

Servicio de Cirugía General. Hospital Civil de Tepic Dr. Antonio González Guevara, Servicios de Salud de Nayarit, Tepic, Nayarit, México.

Exposure and infections by Trypanosoma cruzi are the fourth cause of loss of potential life years between parasitic and infectious diseases. We describe the case of a 11-year-old patient with intestinal occlusion, surgically treated with intestinal volvulus, the surgical specimen is sent to histopathology reporting Chagasic megacolon. The age range of presentation is a challenge in the absence of nonspecific symptoms. Read More