MEGACOLON AND MEGARECTUM IN THE ADULT

Severe constipation in adults with megarectum may be a manifestation o f Hirschsprung's disease or idiopathic megarectum. The differential di agnosis is discussed in the light of two case histories. Total abdomin al proctectomy with coloanal anastomosis eliminated the aganglionic re ctal segment in Hirschsprung's disease and the adynamic distal colorec tum of idiopathic megarectum respectively. The surgical and functional results of a hand-sewn transanal end-to-end-anastomosis were excellen t in both patients.