Adult Hirschsprung's disease. Results of the Duhamel's procedure

Abstract

Eleven patients with adult Hirschsprung's disease were treated at Seoul National University Hospital (SNUH, 8 cases) and Chosun University Hospital (CUH, 3 cases) between 1985 and 1992. Of the 11 patients, seven were male. The age of the patients ranged from 11 to 30 years, and all presented with chronic constipation and recurrent faecal impactions that required periodic enemas and laxatives. The Duhamel's operation, as a single or staged procedure, was performed in all patients. Levels of aganglionosis in 9 patients were confined to the rectosigmoid colon (82%). There were three major post-operative complications. Two patients developed fistula-in-ano at the anastomotic site, and one patient developed ileus. However, these complications resolved with conservative management. The longterm results were excellent except for one patient who developed impotence. The mean frequency of bowel movements was usually once or twice a day without the aid of other treatments. Our results indicate that Duhamel's operation is a highly acceptable procedure in the management of adult Hirschsprung's disease.