Idiopathic megarectum complicating pregnancy: Report of a case

Pregnancy often exacerbates constipation in young women with chronic consti pation syndromes. The presence of the fetus presents a challenge in both th e diagnosis and treatment of these syndromes. This study was conducted to r eport a rare case of idiopathic megarectum complicating a pregnancy. An agg ressive polyethylene glycol (PEG) regimen allowed the patient to carry the child to term and to have a normal vaginal delivery. Successful proctocolec tomy was performed with coloanal anastomosis 3 months postpartum. The patie nt has been free of constipation for 18 months without the need for cathart ics or laxatives. All efforts to avoid operative intervention should be mad e in constipated patients during pregnancy. This principle holds true even in the setting of dilated large bowel. Idiopathic megarectum and the manage ment of constipation in pregnancy are discussed. (Am J Gastroenterol 2000;9 5: 2969-2972. (C) 2000 by Am. Coll. of Gastroenterology).