Megarectum in pregnancy causing coital penetration failure

Rabiatul Adawiah A. Basir, Mohd Fadliyazid Ab Rahim, Rozliana Johari, Roziana Ramli


Megarectum rarely occur in adults. Rectal innervation abnormality or rectal muscle dysfunction could be the underlying pathophysiology, but there are cases where no specific cause is found. Only a handful of cases of megarectum in pregnancy were reported in the literature. Raised progesterone and reduced motilin level during pregnancy may affect bowel motility and predispose pregnant patients to this unusual condition. Clinical presentation ranges from bowel symptoms e.g. chronic constipation, nausea, vomiting and abdominal pain to dysfunctional labour including labour dystocia and obstructed labour. We hereby present a 23 year old lady in early pregnancy who presented with coital penetration failure due to megarectum. We wish to discuss the impact, outcome and management of this rare condition in pregnancy.


Megarectum, Pregnancy, Coital penetration failure

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Nakayama Y, Uehara T, Akiyama M, Minagawa N, Torigoe T, Fujimoto N. Postoperative megarectum in an adult patient with imperforate. Case Rep Gastrointestinal Med. 2015;2015:613926.

Preston DM, Lennard-Jones JE, Thomas BM. Towards a radiologic definition of idiopathic megacolon. Gastrointest Radiol. 1985;10(2):167-9.

Plas RN. Megarectum in constipation. Arch Dis Child. 2000;83(1):52-8.

Chute DJ, Cox J, Archer ME, Bready RJ, Reiber K. Spontaneous rupture of urinary bladder associated with massive fecal impaction (fecaloma). Am J Forensic Med Pathol. 2009;30(3):280-3.

Ryu A, Mun ST, Lee HJ, Moon G. A case of Hirschsprung's disease diagnosed during pregnancy. J Obstetr Gynaecol. 2017;37(1):97-9.

Kurdoglu Z, Dirik D, Kurdoglu M, Iliklerden UH. An unusual cause of abdominal mass in pregnancy: dolichomegacolon. Acta Medica Mediterranea. 2014;30:543.

Grasby ED, Higgins BK. Megacolon in pregnancy causing dystocia. J Obstet Gynaecol Br Emp. 1955;62(6):912-3.

Erik MD, Donald MD, Erol MD. Idiopathic megarectum complicating pregnancy: report of a case. Am J Gastroenterol. 2000;95(10):2969-72.

Kouki S, Mansoura WB. MRI Diagnosis of megarectum in pregnant women. BMJ. 2018:224418

Resta P, Nardelli GB, Mincato C, DeBastiani BM. Hirschprung’s disease and pregnancy: a case report. Eur J Obstet Gynecol Reprod Biol. 1979;9(1):51-3.

Figueiredo A, Martins I, Palma F, Alves MJ, De Barros C. Hypoganglionosis in pregnancy: a case report. J Med Case Rep. 2012;6:297.

Gladman MA, Scott SM, Lunniss PJ, Williams NS. Systematic Review of Surgical Options for Idiopathic Megarectum and Megacolon. Ann Surg. 2005;241(4):562-74.

Sultan AH, Kamm MA, Hudson CN, Bartram CI. Effect of pregnancy on anal sphincter morphology and function. Int J Colorect Dis. 1993;8:206-9.

Gladman MA. Systematic review of surgical options of idiopathic mgearectum and megacolon. Ann Surg. 2005;241:562-74.