Adult Hirschsprung's disease

Hirschsprung's disease is rare in adults. a constant symptom of the disease is chronic refractory constipation. Barium enema showing a distal narrow segment with a cone-shaped transition zone to proximal dilatation suggests the diagnosis; ano-rectal manometry may be helpful if the anorectal inhibitory reflex is absent. The diagnosis is confirmed by the absence of ganglion cells from the rectal wall biopsy. The therapy is surgical. Combined transabdominal-transanal procedures are the most commonly used therapeutic modalities. The case of a 34-year-old man with chronic constipation since childhood is presented. His bowel motion was once every 3-4 weeks. The diagnosis was suspected on history and finding on barium enema, and confirmed by histopathological examination. A modified Duhamel's procedure led to a successful outcome.