Distal intestinal obstruction syndrome: an important differential diagnosis for abdominal pain in patients with cystic fibrosis

Abstract

As life expectancy for those with cystic fibrosis (CF) now exceeds 40 years of age, adult hospitals away from specialized CF services are being exposed more frequently to people with acute complications of CF. Well-known manifestations of CF include pulmonary disease and pancreatic insufficiency with malabsorption. However, a less well-known entity is distal intestinal obstruction syndrome (DIOS), which is an important cause of obstructive symptoms in people with CF that must be differentiated from other causes of bowel obstruction. However, one confounding factor is that adults with CF may have elements of both DIOS and mechanical bowel obstruction due to adhesions from previous operations. A recent tragic outcome in a young adult with CF highlights the need for all doctors, both junior and senior, especially those who are not directly involved in day-to-day CF care, to understand the features of DIOS and the appropriate management, which differs from that of a mechanical bowel obstruction. This review aims to highlight the clinical and pathophysiological features of DIOS, differentiate it from other causes of bowel obstruction and contrast management strategies. Improved knowledge of DIOS will help to facilitate appropriate recognition and permit optimal, multidisciplinary management of this CF complication.© 2019 Royal Australasian College of Surgeons ANZ J Surg 90 (2020) 681-686ANZJSurg.com

Value of Humanized Nursing under Emergency Green Channel on Gastrointestinal Function Recovery in Patients with Acute Intestinal Obstruction after Operation

“…Intestinal obstruction is an obstacle to the passage of intestinal contents caused by various reasons, which leads to clinical symptoms such as abdominal pain, constipation, vomiting, absence of defecation, and exhaustion in patients, and even results in systemic physiological disorders and endangers life safety [1]. Acute intestinal obstruction (AIO) is an extremely common type of intestinal obstruction, which has the characteristics of rapid onset, complex signs, and changeable causes [2]. Previous data revealed that AIO patients are unable to eat due to frequent vomiting, which can rapidly lead to decreased blood volume and hemoconcentration, and even endanger the life of patients when it is serious [3].…”

Alleviation of depression-like behavior in a cystic fibrosis mouse model by Hdac6 depletion

“…Loss of function of the cystic fibrosis transmembrane conductance regulator (CFTR) chloride channel causes varied physiological malfunctions including chronic lung inflammation 1 , CF-related diabetes 2 , impaired growth and weight 3 , 4 and obstructive bowel disease 5 all contributing to a disease that is difficult to manage. While advances in health care have prolonged lifespan, stresses related to early mortality, repeated hospitalization and management of a chronic disease contributes to poor mental health in CF patients including depression and anxiety 6 – 10 .…”

Intestinal obstruction and cystic fibrosis: a case report

“…CT scan of the abdomen demonstrates proximal small bowel dilatation with inspissated fecal material in the bowel. 9 Appendicitis, appendicular mucocele or complete occlusion must be ruled out. The treatment of PIOS is above all empirical in the absence of controlled and randomized studies.…”