Adult Hirschsprung's disease. An experience with the Duhamel-Martin procedure with special reference to obstructed patients.

A two-stage management of six adult patients with Hirschsprung's disease of the rectum and rectosigmoid, with obstruction (two patients) or enormous dilatation of the proximal innervated colon is reported. A preliminary transverse loop colostomy was carried out urgently in two patients because of colonic obstruction, and electively in four patients; at the same time, a full-thickness rectal wall biopsy was taken in all patients to establish the diagnosis. Reconstruction was performed four to six months later with Martin's modification of the Duhamel procedure.