case_images: PMC11582523_01
case_images: Anteroposterior abdominal X-ray performed with the patient in a standing position. Coprostasis is observed in the entire colonic frame (black circle), with significant gas distension at the level of the splenic angle of the colon.
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case_images: Therefore, volvulus was suspected and thus, an abdominal X-ray (Fig. 1), and 1 h later an abdominal computed tomography (CT) scan with intravenous contrast were performed (Fig. 2).
case_images: (A) Intraoperative image during the second surgery, where Soave's procedure was performed. (B) Resected sigmoid colon.
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case_images: An exploratory laparotomy was performed, at which time no volvulus was found, and a sigmoid colon distention of 11 cm in diameter was noted (Fig. 3).
case_images: Histopathological analysis, stained with hematoxylin and eosin. (A) Proximal and middle third of the sigmoid colon illustrating submucosal and myenteric plexuses of the muscularis propria with ganglion cells decreased in number or without them (black circles) at x40 magnification. (B and C) Distal 6 cm of the sigmoid colon without ganglion cells in the submucosal and myenteric plexuses at x20 and x40 magnification, respectively.
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case_images: The subsequent histopathological diagnosis confirms the aganglionosis and hypoganglionosis of the sigmoid colon in its last 6 cm, confirming the diagnosis of short-segment adult Hirschprung's disease (Fig. 4).