Dolichocolon Presenting with Bilateral Hydronephrosis in a Neonate

Abstract

Background: Dolichocolon is an inborn anatomic variant of the colon with redundancies often causing constipation and/or volvulus presenting in childhood, adolescence, or adulthood. To the best of our knowledge, this is the first case of dolichocolon presenting in infancy with constipation and bilateral hydronephrosis. Case Presentation. A nineteen-day-old neonate presented to the emergency department with severe constipation and discomfort. During his admission, he developed pyelonephritis, and subsequent ultrasound of the kidneys and bladder showed bilateral hydroureteronephrosis. A barium enema was performed and it showed a dolichocolon. Enemas and lactulose were initiated with good effect on both the constipation as well as the hydronephrosis.

Conclusions: Dolichocolon in a neonate can cause severe constipation which could also lead to an obstructive nephropathy if untreated. Monitoring of urine flow might be indicated when a neonate presents with severe constipation.

Figure 1

Renal and bladder imaging. (a). Hydronephrosis of the left kidney. (b). Hydronephrosis of the right kidney. (c). Micturation cystourethrogram (filling phase-normal bladder wall). (d) Micturation cystourethrogram (voiding phase-normal urethra).

Figure 2

Barium enema X-ray. Dolichocolon (additional curves at sigmoid and transverse colon, arrows), no strictures, no pathological bowel dilatations, and no signs of Hirschsprung's disease.