Cystic Fibrosis

last updated: September 2, 2016

Orlando Debesa

Distal Intestinal Obstruction Syndrome (DIOS)

  • obstruction of the distal part of the small intestine (cecal area)

  • thick intestinal content

  • occurs in 20% of adults with cystic fibrosis, especially with pancreatic insufficiency

  • Risk factors

    • dehydration​

    • change of diet

    • poor compliance with pancreatic enzymes

  • 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)

  • difficult to differentiate from constipation

  • Tx:

    • enema by fluoroscopy (6-10L)

    • water-soluble (eg. gastrografin) enema instillation reduces surgical intervention

    • hydration

    • laxatives

... but I would more especially commend the clinician who, in acute diseases, by which the bulk of mankind are cutoff, conducts the treatment better than others.
 
Hippocrates, 400 BC