Modified Duhamel with lateral anal sphincterotomy and coloanal stump for adult Hirschsprung's disease: A case series

Introduction: Hirschsprung's disease (HSCR) or megacolon congenital is the most common congenital intestinal motility disorder and characterized by the absence of ganglion cells (aganglionosis) in the myenteric plexus and submucosa of the distal intestine. Presentation of case: This study reports three cases of adult HSCR, with all young female patients who underwent colostomy for obstructive ileus. The chosen definitive therapies were Duhamel pull-through procedure combined with a temporary coloanal stump. Discussion: The three patients underwent Duhamel pull-through procedure with temporary anal stump in conjunction with stoma reversal. The temporary anal stumps were removed within 1-2 weeks after pull-through procedure. All patients were discharged from the hospital and underwent routine follow-up. All patients had fecal incontinence in early follow-up which resolved shortly afterwards. Long term follow-up showed normal intestinal functions and good cosmetic results. Conclusions: The combination of Duhamel pull-through procedure with temporary coloanal stump in definitive therapy of adults with HSCR is a safe and effective technique.