Recurrence of Chagasic Megacolon After Surgical Treatment: Clinical, Radiological, and Functional Evaluation

Chagas disease in the differential diagnosis of megacolon

“…The other is the Habr-Gama technique that causes the posterior colorectal anastomosis, immediately, with acceptable results (8). Subsequently, new variations have been postulated as the rectosigmoidectomy with ileal interposition, with good results and decreased recurrence (9,10). Although CHD is a tropical disease we have to think about it, in front of patients, especially from South America, who come to our clinic presenting symptoms secondary to the presence of digestive megavísceras.…”

Long‐term follow up of abdominal rectosigmoidectomy with posterior end‐to‐side stapled anastomosis for Chagas megacolon

“…Araújo et al. [28] reported recurrent constipation at a mean follow up of 17.7 years. In these patients, barium enema after rectosigmoidectomy showed dilatation of the left colon, validating the close association between clinical and radiological findings.…”

Depopulation of interstitial cells of cajal in chagasic megacolon: towards tailored surgery?

“…Main objectives are the relief of constipation and to reduce or nullify the risk of complications such as volvulus or fecal impaction 3 . Operations for Chagasic megacolon comprise a myriad of techniques that involve different extents of colon resection and anastomotic levels, resulting in variable operative morbidity and recurrence.…”

“…Previous studies on colonic involvement have described degeneration and subsequent decreased number of intrinsic myenteric neurons 1,18,24,25 . The plexus theory hypothesis when denervation mainly affects the rectum might be confirmed by the high constipation recurrence rate when sigmoid resection and high colorectal anastomosis is attempted for surgical treatment 3 . Nevertheless, since almost all such data were obtained in Brazilian patients as single studies on a specific aspect, it might be true that this theory may not clarify important issues such as the discrepancy between congenital and Chagasic megacolon in terms of aganglionosis 8 .…”