MANY theories have been postulated to account for 'congenital megacolon' since the classical description by Hirschsprung in 1888. At first the dilated bowel of the megacolon attracted most of the attention but later most features of the disease were attributed to the absence of ganglion cells in an undilated segment of distal bowel. More recently, however, morphological and physiological observ...

A 43 year old woman in remission from acute myeloid leukaemia developed abdominal pain, severe melaena, diarrhoea and gram-negative septicaemia whilst severely pancytopenic following consolidation chemotherapy. Subsequently, serial abdominal X-rays showed a progressive toxic megacolon. Conservative management was attempted but, because of radiological evidence of increasing colonic dilatation a...