NDLI: Colorectal cancer at the anastomotic site following childhood surgery for hirschsprung disease: a rare case report

Content Provider	Springer Nature : BioMed Central
Author	Mehdorn, Matthias Rhode, Philipp Gosemann, Jan-Hendrik Grunwald, Katja Meyer, Hans-Jonas Lacher, Martin Stelzner, Sigmar
Abstract	Background The present case of a colorectal adenocarcinoma at the anastomotic site of a colorectal anastomosis after childhood surgery for Hirschsprung disease is a rare report of such pathology. Possibly, the altered anatomy after Duhamel procedure may pose a risk for carcinogenesis in those patients. The previously surgically opened plane of the mesorectal fascia, which is usually dissected during total mesorectal excision in rectal cancer, and the impossibility to differentiate from colon or rectal cancer in this case influence oncologic treatment strategies. Furthermore, the case highlights functional aspects of lower anterior resection syndrome before and after rectal cancer surgery with a coloanal anastomosis and how this influences quality of life. Case presentation We report a rare case of a 54-year-old male with a history of Hirschsprung disease, treated with a Duhamel procedure during childhood, who developed colorectal cancer at the site of the colorectal anastomosis. The Duhamel procedure, a common surgical technique in Hirschsprung disease, involves creating a deep colorectal anastomosis with a retained rectal stump. The tumor, a moderately differentiated adenocarcinoma, was treated with total mesorectal excision and intersphincteric resection with a hand-sewn coloanal anastomosis and a loop ileostomy. Postoperative complications included paralytic ileus and urinary retention, but the ileostomy was successfully reversed. Despite increased LARS (lower anterior resection syndrome) scores postoperatively, the patient adapted well, reporting minimal impact on quality of life. In the short term of 1.5 years post-surgery, the patient is disease-free. Conclusion This case highlights the need for awareness of potential colorectal cancer development in patients with a history of Hirschsprung disease and emphasizes the importance of individualized management and close surveillance strategies.
Related Links	https://wjso.biomedcentral.com/counter/pdf/10.1186/s12957-025-03754-w.pdf
Ending Page	6
Page Count	6
Starting Page	1
File Format	HTM / HTML
ISSN	14777819
DOI	10.1186/s12957-025-03754-w
Journal	World Journal of Surgical Oncology
Issue Number	1
Volume Number	23
Language	English
Publisher	BioMed Central
Publisher Date	2025-03-28
Access Restriction	Open
Subject Keyword	Surgical Oncology Hirschsprung disease Rectal cancer Duhamel procedure Intersphincteric resection Case report
Content Type	Text
Resource Type	Case study
Subject	Oncology Surgery
Journal Impact Factor	2.5/2023
5-Year Journal Impact Factor	2.8/2023

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