成人先天性巨结肠的诊断与外科治疗

目的探讨成人先天性巨结肠的诊断与外科治疗。方法回顾性分析1992年6月至2004年6月问收治的15例成人先天性巨结肠患者的临床资料。结果15例患者年龄17．54岁。人院前有9．5个月至50．0年(平均21．4年)的长期便秘、腹胀史；6例患者有急性腹痛史；均无脱水或营养不良表现。钡剂灌肠可见肠管狭窄段和扩张段。予以Soave手术2例，次全结肠切除加结肛吻合术13例；术后所有患者排便功能优良。结论自幼长期慢性便秘史和钡灌肠检查是诊断的主要依据；结肠次全切除加结肛吻合术是安全有效的手术方式。

Diagnosis and surgical management for adult Hirschsprung's disease

OBJECTIVE: To investigate the diagnosis and surgical management of adult Hirschsprung's disease. METHODS: Clinical data of 15 patients with adult Hirschsprung's disease were reviewed retrospectively from June 1992 to June 2004. RESULTS: Patients age ranged from 17 to 54 years old. The main manifestations included long-term (ranged from 9.5 month to 50 years) constipation and abdominal distention. Acute abdominal pain occurred in six patients, but no sign of de hydration and malnutrition occurred in all patients. Bowel stenosis and dilation could be examined by barium enema. Soave procedure was performed in 3 patients, subtotal colectomy with coloanal anastomosis was performed in twelve patients. The function of defecation was improved in all patients after operation. CONCLUSIONS: The diagnosis of adult Hirschsprung's disease mainly depends on the history of constipation from infant and barium enema. Subtotal colectomy with coloanal anastomosis is an effective and safe operative procedure.