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Segmental Dilatation of the Intestine

  • Yoshiaki TakahashiEmail author
  • Yoshinori Hamada
  • Tomoaki Taguchi
Chapter

Abstract

Segmental dilatation of the intestine (SD) is a rare lesion defined as limited bowel dilatation with a three- to fourfold increase in size with an abrupt transition between the normal and dilated bowel and no intrinsic or extrinsic barrier distal to the dilatation. It was first described by Swenson and Rathauser in 1959, and over 100 cases have been reported since then. Several theories were proposed to explain this malformation; however, its cause remains unknown.

More than half of the cases are discovered in neonatal periods. Neonates with SD usually present with features of intestinal obstruction within days of birth. On the other hand, older children present with anemia, hypoproteinemia, malabsorption, and gastrointestinal bleeding. Preoperative diagnosis is sometimes difficult because of the clinical diversity and the lack of specificity of radiological investigations. Patients with an unexplained obstructive intestinal pattern are occasionally found at surgical exploration. The usual finding on laparotomy is localized dilatation of an isolated, well-defined segment of bowel with apparently normal bowel proximal and distal to this segment.

The definitive treatment is resection of the dilated segment and anastomosis of the normal segments of the intestine. Most patients have uneventful course after surgical resection, and prognosis is excellent. In most cases, histology of the resected segment is usually normal. However, some of the cases showed hypertrophied or very thin muscle layer in the involved segment in histopathological evaluation. The dislocation of the myenteric plexus and the ectopic pancreatic or gastric tissues is reported in dilated intestinal segment in some cases.

Keywords

Segmental dilatation Intestine Colon Neonate Criteria Intestinal obstruction Surgical resection Histopathology Allied disorders of Hirschsprung’s disease 

Notes

Acknowledgment

The authors wish to acknowledge Dr. K. Ohama and Dr. N. Ishikawa for offering the data of a case.

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Copyright information

© Springer Nature Singapore Pte Ltd. 2019

Authors and Affiliations

  • Yoshiaki Takahashi
    • 1
    Email author
  • Yoshinori Hamada
    • 2
  • Tomoaki Taguchi
    • 1
  1. 1.Department of Pediatric Surgery, Graduate School of Medical SciencesKyushu UniversityFukuokaJapan
  2. 2.Department of SurgeryKansai Medical UniversityOsakaJapan

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