Chronic Idiopathic Intestinal Pseudo-Obstruction (original) (raw)
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Chronic intestinal pseudo-obstruction: a diagnosis to be considered
Revista Espanola De Enfermedades Digestivas, 2009
Chronic intestinal pseudoobstruction (CIPO) is a rare entity characterized by recurrent clinical episodes of intestinal obstruc - tion in which no mechanical cause is identified. There are multiple causes for this syndrome but two main groups can be distin - guished: a) secondary to a systemic non-gastrointestinal disease; and b) primary or idiopathic originated from alterations in the components of
Chronic Idiopathic Intestinal Pseudo-obstruction A Surgical Approach
Annals of Surgery, 1980
Chronic idiopathic intestinal pseudo-obstruction is an increasingly recognized syndrome in which patients usually present with an acute or chronic history suggestive of intestinal obstruction, although no obstructing lesion is found at surgery. The diagnosis can be suspected in most cases from the clinical presentation. A diagnostic evaluation should be undertaken and exploratory laparotomy avoided if the diagnosis is confirmed on the basis of the radiographic and manometric data. If, in the acute presentation, exploratory laparotomy proves unavoidable, and dilated, nonmechanically obstructed bowel is found, a full-thickness biopsy specimen should usually be taken and the abdomen closed. A carefully chosen, palliative procedure should be reserved for patients who have well defined clinicoanatomic patterns of involvement, and who are incapacitated by their symptoms despite medical management.
Pathophysiology, Diagnosis, and Management of Chronic Intestinal Pseudo-Obstruction
Journal of Clinical Gastroenterology, 2018
Chronic intestinal pseudo-obstruction (CIPO) is a rare disorder characterized by an impairment of coordinated propulsive activity in the gastrointestinal (GI) tract, which clinically mimics mechanical intestinal obstruction. CIPO is the most severe and debilitating form of GI dysmotility. CIPO may be primary or be secondary to pathology at any level of the brain-gut axis as well as systemic disease. The clinical features of CIPO are pleomorphic and largely depend on the site and extent of the segment of the GI tract involved. The diagnostic approach includes the need for investigations to exclude mechanical GI obstruction, screening for causes of secondary CIPO and the identification of the disease phenotype as well as the prompt recognition and treatment of complications such as malnutrition and small intestinal bacterial overgrowth. In managing this disorder, a holistic, multidisciplinary approach is needed with judicious use of pharmacotherapeutic agents. While currently there are no specific therapeutic modalities for CIPO, treatment is largely directed at maintaining adequate nutrition and electrolyte balance and enhancing coordinated GI motility. Surgery should be avoided unless advisable for carefully selected patients and may include stoma formation. This narrative review provides a concise overview of the literature on this rare, severe and complex disorder, and highlights the need and areas for further research to improve both diagnostics and therapeutics.
Clinical journal of gastroenterology, 2011
Intestinal pseudo-obstruction is a clinical syndrome in which the clinical symptoms of intestinal obstruction appear without mechanical obstruction of the intestine. We searched for articles from Japana Centra Revuo Medicina for the period 1983-2009 using the keywords 'chronic' and 'intestinal pseudo-obstruction'. 124 articles were identified, and of these 121 cases were investigated using our diagnostic criteria. The patients were between 0 (just after birth) and 84 years of age, indicating that chronic intestinal pseudo-obstruction (CIP) can occur at any age. The mean age was 43.6 years and the median age was 47 years. Forty-nine patients were male and 72 were female, showing a slight tendency towards female predominance. Five cases (4.2%) had a definitive family history. Of the identified causes of secondary CIP, systemic sclerosis was the most common. Abdominal bloating was the most common initial symptom, seen in 90 (81%) patients. Patients having poor intestina...
Chronic intestinal pseudo-obstruction: treatment and long term follow up of 44 patients
Archives of Disease in Childhood, 1999
Aims-To document the long term course of chronic idiopathic intestinal pseudoobstruction syndrome (CIIPS) in children with defined enteric neuromuscular disease, and the place and type of surgery used in their management; in addition, to identify prognostic factors. Methods-Children with CIIPS were investigated and treated prospectively. Results-Twenty four children presented congenitally, eight during the 1st year of life, and 10 later. Twenty two had myopathy and 16 neuropathy (11 familial). Malrotation was present in 16 patients, 10 had short small intestine, six had nonhypertrophic pyloric stenosis, and 16 had urinary tract involvement. Thirty two patients needed long term parenteral nutrition (TPN): for less than six months in 19 and for more than six months in 13, 10 of whom are TPN dependent; 14 are now enteral feeding. Prokinetic treatment improved six of 22. Intestinal decompression stomas were used in 36, colostomy relieved symptoms in five of 11, and ileostomy in 16 of 31. A poor outcome (death (14) or TPN dependence (10)) was seen with malrotation (13 of 16), short small bowel (eight of nine), urinary tract involvement (12 of 16), and myopathic histology (15 of 22). Conclusions-In CIIPS drugs are not helpful but decompression stomas are. Outcome was poor in 24 of 44 children (15 muscle disorder, 10 nerve disease).