Ann Clin Case Rep | Volume 7, Issue 1 | Case Report | Open Access

Huge Megacolon Complicating Chronic Colonic Volvulus in a Pregnant Lady with Partial Hirschsprung Disease: A Case Report and Review of the Literature

Sayed El-Akhras1, Mohamed H Salama1,2, Mohamed Abo-Elenen3, Ali Elbadry4, Diaa Abdelhalim1,5, Panayiotis Tanos6* and Vasilios Tanos7,8

1Department of Gynecology and Obstetrics, Omam Hospital, Egypt
2Department of Obstetrics and Gynecology, Ain Shams University, Egypt
3Department of Internal Medicine, Omam Hospital, Egypt
4Department of Colorectal Surgery, Omam Hospital, Egypt
5Department of Obstetrics and Gynecology, Al-Galaa Teaching Hospital, Egypt
6Institute of Applied Health Sciences, University of Aberdeen and Aberdeen Royal Infirmary, UK
7University of Nicosia-Medical School, Aretaeio Hospital, Cyprus
8Department of Research and Development, Omam Hospital, Egypt

*Correspondance to: Panayiotis Tanos 

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Abstract

Introduction: Megacolon is a rare, but potentially deadly complication of colonic inflammation. Colonic volvulus is the third most common cause of large bowel obstruction worldwide. Hirschsprung’s Disease (HD), is a rare congenital colonic disorder. However, it can present in adulthood and can have particularly high risk of obstetric complications to both the mother and the fetus with main complication being refractory chronic constipation. Literature review detected 6 articles reporting the clinical manifestations and the management of patients with refractory chronic constipation in pregnancy of 9 cases. Case: In this article, a complicated case of a 36 weeks parous lady, G3P2 with megacolon is presented. The consequences and delivery outcomes, of chronic constipation during pregnancy, due to chronic volvulus of an already dilated colon, on top of enteric atony due to partial HD, are discussed. Conclusion: Preventive dietary measures, laxatives and frequent antenatal care may probably reduce the risk of complicated megacolon, caesarian section and premature delivery. Chronic constipation during reproductive age should merit further clinical attention during antenatal care, as well as multi-disciplinary approach in the management and treatment of these patients.

Citation:

El-Akhras S, Salama MH, Abo-Elenen M, Elbadry A, Abdelhalim D, Tanos P, et al. Huge Megacolon Complicating Chronic Colonic Volvulus in a Pregnant Lady with Partial Hirschsprung Disease: A Case Report and Review of the Literature. Ann Clin Case Rep. 2022; 7: 2311.

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