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April 1968

Radical Enterectomy for Hereditary Megaduodenum

Author Affiliations

St. Louis
From the Department of Surgery, Washington University School of Medicine, Barnes Hospital, and the John Cochran Veterans Administration Hospital, St. Louis.

Arch Surg. 1968;96(4):549-553. doi:10.1001/archsurg.1968.01330220065012

DISTENSION and dilatation of the duodenum encountered in North American clinical practice is most apt to be related to mechanical obstruction of the duodenum. On the other hand, Barnett and Wall1 were able to collect from the English literature six cases of aganglionosis of the duodenal myenteric plexus with megaduodenum. Individual case reports of duodenal ileus related to degenerative changes in the myenteric plexus appear from time to time.2-4 In Brazil megaduodenum as well as megaesophagus and megacolon are produced in chronic Chagas' disease due to infestation by Trypanosoma cruzi whose neurotoxin damages the ganglion cells of the duodenal myenteric plexus.5 This disease in its acute form has been reported in Texas.6

Law and Ten Eyck7 in 1962 reported the association of megaduodenum and megacystis in nine members of a family of Italian extraction. Earlier, Weiss8 had described megaduodenum alone in six members of

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