Abstract：
Idiopathic megarectum is characterized by abnormal, pronounced rectal dilatation in the absence of identifiable organic pathology. Idiopathic megarectum is uncommon and under-recognized. This study aims to describe the clinical features and management of idiopathic megarectum.
A retrospective review was undertaken on patients diagnosed with idiopathic megarectum with or without idiopathic megacolon over a 14-year period until 2021. Patients were identified from the hospital\'s International Classification of Diseases codes, and pre-existing clinic patient databases. Patient demographics, disease characteristics, healthcare utilization and treatment history data were collected.
Eight patients with idiopathic megarectum were identified; half of the patients were female, with the median age of symptom onset being 14 years (interquartile range [IQR] 9-24). The median rectal diameter measured was 11.5 cm (IQR 9.4-12.1). The most common presenting symptom was constipation, bloating and faecal incontinence. All patients required prior sustained periods of regular phosphate enemas and 88% were using ongoing oral aperients. Concomitant anxiety and or depression were found in 63% of patients and 25% were diagnosed with an intellectual disability. Healthcare utilization was high with a median of three emergency department presentations or ward admissions related to idiopathic megarectum per patient over the follow-up period; 38% of patients required surgical intervention during the period of follow-up.
Idiopathic megarectum is uncommon and associated with significant physical and psychiatric morbidity and high healthcare utilization.
A retrospective review was undertaken on patients diagnosed with idiopathic megarectum with or without idiopathic megacolon over a 14-year period until 2021. Patients were identified from the hospital\'s International Classification of Diseases codes, and pre-existing clinic patient databases. Patient demographics, disease characteristics, healthcare utilization and treatment history data were collected.
Eight patients with idiopathic megarectum were identified; half of the patients were female, with the median age of symptom onset being 14 years (interquartile range [IQR] 9-24). The median rectal diameter measured was 11.5 cm (IQR 9.4-12.1). The most common presenting symptom was constipation, bloating and faecal incontinence. All patients required prior sustained periods of regular phosphate enemas and 88% were using ongoing oral aperients. Concomitant anxiety and or depression were found in 63% of patients and 25% were diagnosed with an intellectual disability. Healthcare utilization was high with a median of three emergency department presentations or ward admissions related to idiopathic megarectum per patient over the follow-up period; 38% of patients required surgical intervention during the period of follow-up.
Idiopathic megarectum is uncommon and associated with significant physical and psychiatric morbidity and high healthcare utilization.
摘要：
目的：特发性大直肠以异常为特征，在没有可识别的器质性病理学的情况下，直肠扩张明显。特发性大直肠病并不常见且未得到充分认可。本研究旨在描述特发性大直肠病的临床特征和治疗。
方法：对诊断为特发性大直肠伴或不伴特发性巨结肠的患者进行了14年的回顾性研究，直至2021年。患者是从医院的国际疾病分类代码中识别出来的，和预先存在的临床患者数据库。患者人口统计学，疾病特征，收集医疗保健利用和治疗历史数据.
结果：确定了8例特发性大直肠患者，其中一半为女性，症状发作的中位年龄为14岁（四分位距[IQR]9-24）。测得的中位直肠直径为11.5cm（IQR9.4-12.1）。最常见的症状是便秘，腹胀和大便失禁。所有患者都需要定期定期进行磷酸盐灌肠，而88％的患者正在使用持续的口服开胃药。在63％的患者中发现了伴随的焦虑和/或抑郁，25％的患者被诊断为智力障碍。在随访期间，医疗保健利用率很高，每位患者的急诊就诊或病房入院与特发性大直肠相关；38％的患者在随访期间需要手术干预。
结论：特发性大直肠病并不常见，并且与显著的身体和精神病发病率以及高医疗保健利用率相关。
方法：对诊断为特发性大直肠伴或不伴特发性巨结肠的患者进行了14年的回顾性研究，直至2021年。患者是从医院的国际疾病分类代码中识别出来的，和预先存在的临床患者数据库。患者人口统计学，疾病特征，收集医疗保健利用和治疗历史数据.
结果：确定了8例特发性大直肠患者，其中一半为女性，症状发作的中位年龄为14岁（四分位距[IQR]9-24）。测得的中位直肠直径为11.5cm（IQR9.4-12.1）。最常见的症状是便秘，腹胀和大便失禁。所有患者都需要定期定期进行磷酸盐灌肠，而88％的患者正在使用持续的口服开胃药。在63％的患者中发现了伴随的焦虑和/或抑郁，25％的患者被诊断为智力障碍。在随访期间，医疗保健利用率很高，每位患者的急诊就诊或病房入院与特发性大直肠相关；38％的患者在随访期间需要手术干预。
结论：特发性大直肠病并不常见，并且与显著的身体和精神病发病率以及高医疗保健利用率相关。
