JOCS
Journal of Comprehensive Surgery

The aim of the Comprehensive Surgery is to publish original research articles of the highest scientific and clinical value at the international level in all surgical fields.

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Case Report
Approach to anal sphincter dysfunctions in a patient with endorectal pull-through procedure
Abstract
The seven-year-old male patient was examined in the pediatric surgery outpatient unit with abdominal distension. He had been operated on for congenital megacolon in the newborn period in another center. After a period of follow-up, he had been re-operated because of a diagnosis of insufficient pull-through, and a second pull-through had been performed. Following this procedure, myectomy and temporary colostomy procedures were reported in a different hospital. After all these treatments, he still had a distension episode, even associated with enterocolitis. In our clinic, we medically treated enterocolitis four times in 5 months. According to the council decision in our department, we decided to use a medically used botulin toxin (Botox) to evaluate a possible internal anal sphincter achalasia (IASA) and injected the Botox into the internal sphincter under anesthesia. Following the procedure, the patient was brought to our attention only once in 4 months with a mild distension. This data encouraged us to perform partial sphincteromy and internal sphincter myectomy. Nine months after the myectomy, the patient was not hospitalized and had a mild distension once. There is a significant improvement in his life quality; as a clear result, we observed and experienced that sphincter-related problems must be taken into account in incurable postoperative obstructive situations related to Hirschsprung's disease.

Keywords : Hirschsprung’s disease, internal anal sphincter, achalasia

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Article available in :
Volume 3, Issue 1, 2025
Page : 22-24
https://doi.org/10.51271/JOCS-0050
Article Information
Received : 28 Ara 2024
Accepted : 05 Şub 2025
Published : 23 Şub 2025
Corresponding Author :

Sevgi Ulusoy Tangül: Department of Pediatric Surgery, Faculty of Medicine, Bozok University, Yozgat, Turkiye

[email protected]
Citation : Ulusoy Tangül S, Şenaylı A. Approach to anal sphincter dysfunctions in a patient with endorectal pull-through procedure. J Compr Surg. 2025;3(1):22-24.

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