Proximal intestinal obstruction syndrome (PIOS) in a patient with cystic fibrosis: A case report

• Published in: Annals of medicine and surgery Vol. 60; pp. 669 - 672
• Main Authors: Morales Morales, Carlos Antonio, Gonzalez-Urquijo, Mauricio, Morales Flores, Luis Fernando, Quevedo-Fernandez, Enrique, Guzmán Huerta, Eduardo Alberto, Virgilio Hernández-Torre, Martín Mauricio
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.12.2020; Elsevier
• Subjects: Bowel obstruction; Case Report; Cystic fibrosis; DIOS; PIOS; PIOS; Cystic fibrosis; DIOS; Bowel obstruction; Case report
• ISSN: 2049-0801; 2049-0801
• DOI: 10.1016/j.amsu.2020.11.063

Distal Intestinal Obstruction Syndrome is a rare complication in patients with cystic fibrosis, which characterized by the accumulation of viscid fecal material, combined with sticky mucous secretions located in the distal ileum adhere to the intestinal wall, causing complete bowel obstruction. We report a case of a 45 years old patient with cystic fibrosis, who presented bowel obstruction secondary to accumulation of fecal material, combined with mucous secretions, in the mid-jejunum. A diagnostic laparoscopy was performed where a dilated jejunum was encountered with impaction of fecal content. Surgery was converted to open surgery, where a longitudinal enterotomy of 5 cm after the transition zone was created, evacuating manually the fecal material with mucous secretion. The patient evolved favorably, without complications. We present a case of a patient with cystic fibrosis presenting with bowel obstruction due to a proximal intestinal obstruction syndrome, which can be diagnosed with the DIOS definition, with the only distinction of a more proximal location in the gastrointestinal tract, such as the stomach, the duodenum, or the jejunum. It is important for the clinician to know the existence of this syndrome at its different locations in the small bowel to treat accordingly. •Proximal Intestinal Obstruction Syndrome is a rare complication in patients with cystic fibrosis.•It is the accumulation of viscid feces with mucous secretions in the small bowel.•It is important to know the existence of this syndrome to treat accordingly.