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Total colonic aganglionosis: management and long-term outcomes at a referral centre

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Topic overview

This 22-year retrospective study examines management of total colonic aganglionosis in an Indian referral center, highlighting diagnostic challenges including incongruent contrast enemas and need for multiple stoma revisions. Despite resource constraints, long-term bowel function outcomes were comparable to developed nations.

Key takeaways

  • Contrast enema is unreliable for TCA diagnosis in LMIC settings—71% were incongruent with final histological findings.
  • Multiple interim surgeries are common before definitive repair—45% required stoma relevelling, median 8 procedures per patient.
  • Long-term outcomes in LMIC can match developed nations—73% achieved favorable bowel function at mean 10-year follow-up.
  • TCA presentation varies beyond neonatal obstruction—36% presented with chronic constipation rather than acute symptoms.
  • Prolonged stoma duration is typical—median 13 months before definitive pull-through surgery at 19.5 months of age.

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How to cite: GlobalCastMD. Total colonic aganglionosis: management and long-term outcomes at a referral centre. GlobalCastMD Medical Library. 2024-11-22. https://dev.library.globalcastmd.com/article/9450?via_space=staycurrentmd

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