Distal Intestinal Obstruction Syndrome (DIOS) in Patients with Cystic Fibrosis After Lung Transplantation

Morton, J.; Ansari, Nabila; Glanville, Allan R.; Meagher, Alan P.; Lord, Reginald V.

doi:10.1007/s11605-009-0924-5

Cited by 40 publications

(32 citation statements)

References 29 publications

(41 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This is consistent with reports from others,28 and may reflect a more aggressive form of the disease 29. All patients in our series who underwent surgery for DIOS had pancreatic insufficiency and were on pancreatic enzyme replacement.…”

Section: Discussionsupporting

confidence: 93%

Gastrointestinal surgery in adult patients with cystic fibrosis

Sharma

Morton

Peckham

et al. 2012

Frontline Gastroenterol

View full text Add to dashboard Cite

Objective Gastrointestinal conditions requiring surgical intervention are becoming increasingly frequent in adults with cystic fibrosis (CF) as life expectancy increases. In addition, patients with CF are at risk of specific gastrointestinal complications associated with their disease. This includes distal intestinal obstruction syndrome (DIOS), which may affect up to 15% of patients, and can present diagnostic and therapeutic challenges. The aim of this study was to determine the nature and frequency of general surgical procedures undertaken in a large cohort of adult CF patients so as to guide future care. Design The medical records of all surviving adult CF patients followed at a large tertiary referral centre in the UK were scrutinised and details retrieved on those who had undergone abdominal surgery after the age of 16 years. Results A total of 377 patients with CF were identified from the prospectively held database. Thirty-three patients had undergone 43 abdominal operations. The median age at surgery was 22.7 years (range 16-58 years). The three most commonly performed operations were: surgery for DIOS (n=9); cholecystectomy (n=8) and fundoplication (n=6). A past history of surgically treated meconium ileus at birth was a significant risk factor for requiring surgery for DIOS as an adult. Conclusions The treatment of DIOS-related complications is one of the main reasons for abdominal surgery in the adult CF population. The general surgical community needs to be increasingly aware of the existence of diseaserelated gastrointestinal conditions in adult CF patients so that treatment can be optimised.

show abstract

Section: Discussionsupporting

confidence: 93%

Gastrointestinal surgery in adult patients with cystic fibrosis

Sharma

Morton

Peckham

et al. 2012

Frontline Gastroenterol

View full text Add to dashboard Cite

show abstract

“…These include complications of intestinal dysmotility (gastric bezoars, distal intestinal obstruction syndrome), biliary tract dysfunction (gastroesophageal reflux, mucosal ulcerations, hepatic cirrhosis, cholelithiasis, cholecystitis, biliary obstruction, acute pancreatitis, pseudomonas colitis, fatty liver), and gastrointestinal malignancy [15][16][17][18][19][20]. These potential complications can complicate the post-transplant course of patients and cause significant morbidity or death, and the immunosuppressive drug regimen that recipients must receive to prevent allograft rejection can cause adverse GI reactions (nausea, diarrhea) or increase the risk of infectious complications (enteric cytomegalovirus infection, pseudomembranous colitis, other GI tract infection).…”

Section: Discussionmentioning

confidence: 99%

Colon cancer in lung transplant recipients with CF: Increased risk and results of screening

Meyer

Francois

et al. 2011

Journal of Cystic Fibrosis

View full text Add to dashboard Cite

In contrast to non-CF recipients, patients with CF displayed a significant incidence of colon cancer (4 of 70 recipients; 5.7%) with onset ranging from 246 days to 9.3 years post-transplant, which may be due to a combination of their underlying genetic disorder plus intense, sustained immunosuppression following lung transplantation. Colonoscopic screening may identify patients with pre-malignant colonic lesions and prevent progression to colonic malignancy.

show abstract

“…Similarities and differences between predisposing risk factors for DIOS and constipation have also been reported. Severe CFTR genotypes, exocrine pancreatic insufficiency (PI), post‐organ transplantation and previous DIOS have been associated with the development of DIOS . There is conflicting evidence regarding a history of MI as a risk factor for DIOS.…”

mentioning

confidence: 99%