Minerva medica
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Megacolon must be considered as a diagnosis in any case of intractable constipation also in the adult. Besides the Hirschsprung's disease and the idiopathic megacolon, which have no apparent organic cause, many other pathologic conditions may produce a marked dilatation of the large bowel. The differential diagnosis depends, after a valuation of the clinical and radiologic features, also from enzymatic, histologic and functional tests. ⋯ The patients with aganglionic megacolon were admitted to our Hospital respectively for an abdominal palpable mass, a volvolus and incontinence. The two patients with idiopathic megacolon showed the same clinical picture of those with Hirschsprung's disease. We choose a surgical therapy in all five patients, with good long-term results.