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becoming a better Clinician
Cystic Fibrosis
last updated: September 2, 2016
Orlando Debesa
Distal Intestinal Obstruction Syndrome (DIOS)
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obstruction of the distal part of the small intestine (cecal area)
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thick intestinal content
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occurs in 20% of adults with cystic fibrosis, especially with pancreatic insufficiency
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Risk factors
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dehydration
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change of diet
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poor compliance with pancreatic enzymes
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S/Sx: abdominal pain, vomiting, palpable mass in abdomen, Xray show stool in colon and air-fluid level in small intestine (usually affects the right colon)
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difficult to differentiate from constipation
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Tx:
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enema by fluoroscopy (6-10L)
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water-soluble (eg. gastrografin) enema instillation reduces surgical intervention
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hydration
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laxatives
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