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Revista chilena de cirugía

versión On-line ISSN 0718-4026


SOTO CASTILLO, DANIEL; BANNURA CUMSILLE, GUILLERMO  y  PENALOZA MONTECINOS, PAULINA. Neuronal intestinal dysplasia causing severe constipation. Report of two cases . Rev Chil Cir [online]. 2006, vol.58, n.1, pp.54-58. ISSN 0718-4026.

Neuronal intestinal dysplasia is an abnormality of intestinal innervation, different from Hirschprung disease, that can be recognized with immunohistochemical techniques. We report two female patients with this disease, aged both 31 years, that had a severe constipation. Barium enema and anorectal manometry were normal. Colonic transit time showed a pattern of colonic inertia in both. One patient was subjected to an anorectal sphincter myomectomy and the other, to a colectomy plus anorectal sphincter myomectomy. Long term follow up showed satisfactory results with normal intestinal habit and without incontinence. Immunohistochemical study of the surgical piece classified the first patient as a type B neuronal intestinal dysplasia and the second patient as a non classifiable neuronal intestinal dysplasia. The pathological criteria for the diagnosis of type B neuronal intestinal dysplasia are not universally accepted and the correlation with symptoms is weak. Therefore the diagnosis of this type of dysplasia is complex and the role of surgical treatment is not completely clear

Palabras clave : Neuronal intestinal dysplasia; constipation; sphincter myomectomy.

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