Long-Term Outcome of Chronic Intestinal Pseudo-Obstruction Adult Patients Requiring Home Parenteral Nutrition

Abstract

In this large cohort of CIPO adult patients with severe intestinal failure, i.e., those requiring HPN, we found a higher survival probability than previously reported. These results should be taken into account when considering intestinal transplantation.

Nationwide survey on adult type chronic intestinal pseudo-obstruction in surgical institutions in Japan

“…Surgical treatment was performed in about two-thirds of patients after consultation in the current series. Although this figure is comparable to those reported previously [5,13], there may be a selection bias because the current questionnaire study was conducted among colorectal surgeons. Notwithstanding, this study clearly showed that surgical treatment was most effective in the large bowel type CIP, less effective in the small bowel type CIP, and least effective in the large and small bowel type CIP.…”

“…Further epidemiological study will be needed to clarify these details. The diseased bowel segments were not clearly specified in most of the previous publications on CIP [1,[3][4][5]. A few other reports included the presence of dilated small bowel in the inclusion criteria of CIP [2,6].…”

Hand-assisted laparoscopic subtotal colectomy with cecorectal anastomosis for chronic idiopathic colonic pseudo-obstruction: report of a case

“…CIIP, on the other hand, does not require surgery, but instead is treated with medications such as prokinetics (8,9) or nutritional support such as central venous nutrition (10) or home parenteral nutrition (11). In some cases, palliative surgery has been performed and improved the quality of life of patients with CIIP (12,13).…”

Chronic Intestinal Pseudo-obstruction: Clinical and Manometric Characteristics in the Chilean Population

“…6,7 The progression of the illness is usually associated with malabsorption and malnutrition, sometimes becoming necessary to resort to parenteral nutrition. 8,9 With regard to the pathophysiology the compromise of intrinsic and extrinsic neural structures, muscles, Cajal cells, or a combination of these have been described. These alterations can be idiopathic when they appear in the absence of other disorders, or may be secondary to a number of different conditions that include neurological, endocrine, metabolic, autoimmune, paraneoplastic syndrome, and infectious diseases.…”

“…11 Western studies have shown a higher frequency of CIPO in females, that ranges from 64% to 68%. 9,12 Intestinal manometry, not always available in all centers, has been considered to be an important contribution to the diagnosis of the syndrome, but the diagnosis cannot rely solely on the study of motility with manometry. It can also contribute to establishing the pathophysiology of the underlying dysmotility: in the presence of contractions of normal amplitude, but which is uncoordinated, it is possible to assume that the intestinal muscle is normal and that the neurogenic control is altered.…”