Clinical Study of Congenital Megacolon

ABSTRACT

The clinical study was made on 38 cases of the congenital megacolon who had been admitted to Dept. of Pediatrics and General surgery, National Medical Center from Jan., 1869 to Dec., 1977 We obtained the following results. 1. The sex ratio was 4.4 1, of male preponderance. 2. The onset of symptoms was within 1 week after birth in majority of the cases. 3. All patients were delivered at fullterm and the familial occurrence was not observed. The associated anomalies were a case of mongolism with congenital heart disease and of congenital hypertrophic pyloric stenosis. 4. In about half of the cases, the definitive diagnosis was made before the age of 6months 5. The clinical symptomes were abdominal distension, constipation, vomiting, diarrhea, visible peristalsis and weight loss in order of frequency. 6. Meconium passage was spontaneous in 41.2% and after digital examination or enema in 58.8%. 7. The majority of the cases(79%) were so called short segment type. One male patient was proved to be total aganglionic colon. 8. The definitive operation was performed in 18 cases, in which 14 cases(77.7%) received Swenson's procedure. The early complications were wound infection, leakage, fistula, pelvic abscess and the late complications were stricture, intestinal obstruction, enterocolitis, fecal impaction, malnutrition in order of frequency. 9. The total mortality rate was 23.7% and the operation mortality was 16.7%. 10. The results of one stage operation was somewhat better than two stage operation. 11. The follow up results were good in 83.3% of operated cases.