Idiopathic Megacolon in an Adolescent Girl: a Case Report on a Rare Disease

Introduction: Idiopathic Megacolon is a rare condition where there is persistent dilatation of colon in the absence of identifiable cause. Symptoms start as early as in childhood or in adulthood. Colectomy have shown to have high success rate in patient with idiopathic megacolon. We reported a case of an adolescent girl with idiopathic megacolon that was successfully treated with colectomy.Presentation of case: A 15 years old girl presented with a complaint of abdominal pain associated with gradual abdominal distension for 1 week duration, not passing flatus and had multiple episodes of vomiting. She was diagnosed to have sigmoid volvulus and underwent endoscopy decompression, however symptoms recurred. Segmental colectomy was performed and she had an uneventful recovery. Discussion: Patient presented with acute intestinal obstruction attributed to sigmoid volvulus with a history of constipation. A diagnostic dilemma between Hirschsprung’s disease with other causes of megacolon occurred as these diseases have similar presenting symptoms. A confirm histopathology of presence of ganglionic cells within the plexus exclude the diagnosis of Hirschsprung’s disease hence the diagnosis of Idiopathic Megacolon was made. Segmental colectomy give good result in relieving patient symptoms of abdominal pain and constipation and one of the recommended surgical options in treating Idiopathic Megacolon.Conclusion: Idiopathic megacolon is a rare disease and for a long time has been a disease of exclusion. Rectal biopsy is important to exclude the diagnosis of Hirschsprung’s Disease. There are wide variety of surgical treatment available in treating Idiopathic megacolon. Segmental Colectomy have shown good success rate.