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Surgery for Acquired Megacolon

DAVID L. DEAN, MD
Arch Surg. 1966;92(5):724-726. doi:10.1001/archsurg.1966.01320230072013.
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MEGACOLON has various causes. Nevertheless, when the term megacolon is used, it is often taken to mean only Hirschsprung's disease, or aganglionic megacolon. Actually the type of megacolon with ganglia present occurs often enough to have more consideration. In some reports this type outnumbers the aganglionic type.1

Megacolon can be classified into three types: (1) aganglionic megacolon (Hirschsprung's disease). The megacolon seen in South America associated with Chagas' disease belongs in this category because the number of myenteric ganglia are greatly reduced in this disease. (2) Acquired megacolon, also called functional megacolon, idiopathic megacolon, psychogenic megacolon, colon inertia, and pseudomegacolon. (3) Megacolon caused by organic obstruction as seen with imperforate anus, tumor, or stricture.

This report is concerned mainly with acquired megacolon. It is written to show that, although many medical and surgical textbooks2,3 and other recent publications1,4,5 on the subject advise nonoperative management of acquired megacolon,

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