Publication:

Intestinal obstruction in cystic fibrosis: a surgeon’s perspective

Background Distal intestinal obstruction syndrome(DIOS) is one of the commonestgastrointestinal manifestation of Cystic Fibrosis. It occurs as a result ofimpaction of mucofeculent material in the ileocaecum and ascending colon. Themedical management is effective in the chronic presentation, but the optimummanagement in the acute presentation is still a grey area.The aim of this study is to retrospectively follow up patients presenting withfeatures of DIOS who had surgical resection of the ileocaecum to assess thelong-term outcome in terms of recurrence of symptoms.

Methods Case notes of eight patients presenting with features of acute DIOS between 2000 and 2006 were retrieved from the Cystic fibrosis unit of a tertiary teaching hospital and analysed.

Results Eight patients were included in this study, male: female ratio of 5:3age range: 18-24. Acute presentation: 6, elective presentation:2. The mainpresenting features were abdominal pain, constipation, vomiting and RIF mass.Six patients had ileocaecectomy; one had a small bowel resection and one anextended right hemicolectomy.Six patients had no further symptoms of DIOS four years post-surgery, two hadfurther symptoms with one requiring further surgery.

Conclusions Ileocaecal resection in patients presenting with acute DIOS is aviable and effective option in management.