{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:47:55Z","timestamp":1787014075500,"version":"build-2736575974"},"reference-count":10,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2016,7,29]],"date-time":"2016-07-29T00:00:00Z","timestamp":1469750400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Digestive Endoscopy"],"published-print":{"date-parts":[[2016,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Hirschsprung's disease (HD) is a congenital disorder characterized by the absence of intrinsic ganglion cells in submucosal and myenteric plexuses of the hindgut; and presents with constipation, intestinal obstruction and\/or megacolon. HD commonly involves the rectosigmoid region (short segment HD), although shorter and longer variants of the disease are described. Standard treatment involves pull\u2010through surgery for short segment HD or posterior anorectal myotomy in selected ultrashort segment candidates. Third space endoscopy has evolved during the past few years. Per oral endoscopic myotomy and per oral pyloromyotomy are described for treatment of achalasia cardia and refractory gastroparesis, respectively. Using the same philosophy of muscle\/sphincter disruption for spastic bowel segments, per rectal endoscopic myotomy could be considered as a treatment option for short segment HD. A 24\u2010year\u2010old male patient presented with refractory constipation since childhood, and habituated to high\u2010dose laxative combinations. Diagnosis was confirmed as adult short segment HD by barium enema, colonoscopic deep suction mucosal biopsies and anorectal manometry. Histopathology confirmed aganglionosis in the distal 15\u00a0cm. By implementing principles of third space endoscopy, per rectal endoscopic myotomy 20\u00a0cm in length was successfully carried out. At 24\u2010week follow up, the patient reported significant relief of constipation and associated symptoms. Sigmoidoscopy, anorectal manometry and barium enema confirm improved rectal distensibility and reduced rectal pressures. The present case report describes the first human experience of per rectal endoscopic myotomy for successful treatment of adult short segment HD.<\/jats:p>","DOI":"10.1111\/den.12689","type":"journal-article","created":{"date-parts":[[2016,6,16]],"date-time":"2016-06-16T01:05:12Z","timestamp":1466039112000},"page":"680-684","source":"Crossref","is-referenced-by-count":36,"title":["Per rectal endoscopic myotomy for the treatment of adult Hirschsprung's disease: First human case (with video)"],"prefix":"10.1111","volume":"28","author":[{"given":"Amol","family":"Bapaye","sequence":"first","affiliation":[{"name":"Shivanand Desai Center for Digestive Disorders Deenanath Mangeshkar Hospital and Research Center  Pune India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gajanan","family":"Wagholikar","sequence":"additional","affiliation":[{"name":"Department of Surgery Deenanath Mangeshkar Hospital and Research Center  Pune India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sameer","family":"Jog","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Intensive Care Deenanath Mangeshkar Hospital and Research Center  Pune India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aditi","family":"Kothurkar","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Deenanath Mangeshkar Hospital and Research Center  Pune India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shefali","family":"Purandare","sequence":"additional","affiliation":[{"name":"Department of Pathology Deenanath Mangeshkar Hospital and Research Center  Pune India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nachiket","family":"Dubale","sequence":"additional","affiliation":[{"name":"Shivanand Desai Center for Digestive Disorders Deenanath Mangeshkar Hospital and Research Center  Pune India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajendra","family":"Pujari","sequence":"additional","affiliation":[{"name":"Shivanand Desai Center for Digestive Disorders Deenanath Mangeshkar Hospital and Research Center  Pune India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahesh","family":"Mahadik","sequence":"additional","affiliation":[{"name":"Shivanand Desai Center for Digestive Disorders Deenanath Mangeshkar Hospital and Research Center  Pune India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Viral","family":"Vyas","sequence":"additional","affiliation":[{"name":"Shivanand Desai Center for Digestive Disorders Deenanath Mangeshkar Hospital and Research Center  Pune India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jay","family":"Bapaye","sequence":"additional","affiliation":[{"name":"Smt. Kashibai Navale Medical College  Pune India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,7,29]]},"reference":[{"key":"e_1_2_6_2_1","first-page":"1565","volume-title":"Nelson Textbook of Pediatrics","author":"Wyllie R","year":"2008"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00383-011-3002-5"},{"key":"e_1_2_6_4_1","first-page":"911","article-title":"Internal sphincter myectomy for adult Hirschsprung's disease: a single institute experience","volume":"93","author":"Pattana\u2010arun J","year":"2010","journal-title":"J. Med. Assoc. Thai."},{"key":"e_1_2_6_5_1","first-page":"109","article-title":"Role of anorectal myectomy in the treatment of short segment Hirschsprung's disease in young adults","volume":"90","author":"Kaymakcioglu N","year":"2005","journal-title":"Int. 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