Top

Surgery Today

Published in:

01-03-2012 | Original Article

Nationwide survey on adult type chronic intestinal pseudo-obstruction in surgical institutions in Japan

Authors: Tadahiko Masaki, Kenichi Sugihara, Atsushi Nakajima, Tetsuichiro Muto

Published in: Surgery Today | Issue 3/2012

Abstract

Background

No appropriate management of chronic intestinal pseudo-obstruction (CIP) has been established.

Patients and methods

The clinicopathological parameters of 103 cases collected by a nationwide questionnaire study were reviewed.

Results

The CIP cases were primary in 86 (83%) cases and secondary in 15 (15%) cases. The age of onset of the primary type was significantly younger than that of the secondary type (p = 0.011). The diseased segments of the bowel were the large bowel in 60 (58%), the small bowel in 17 (17%), and both in 23 (22%) cases, respectively. Abdominal distension and pain were common symptoms regardless of the types of the diseased bowel; however, constipation was frequently seen in the large bowel type (p = 0.0258). Vomiting and diarrhea were seen with marginally higher frequency in the small bowel type (p = 0.0569, 0.0642). Surgical treatment was most effective in the large bowel type, less effective in the small bowel type, and least effective in the large and small bowel type. The prognosis of the primary CIP was significantly better than that of the secondary CIP (p = 0.033).

Conclusions

The segments of the diseased bowels should be considered in determining the indications for surgical treatments in CIP patients.

Available only for authorised users

Stanghellini V, Cogliandro RF, De Giorgio R, Barbara G, Salvioli B, Corinaldesi R. Chronic intestinal pseudo-obstruction: manifestations, natural history and management. Neurogastroenterol Motif. 2007;19:440–52.CrossRef

Connor FL, Di Lorenzo C. Chronic intestinal pseudo-obstruction: assessment and management. Gastroenterology. 2006;130:S29–36.PubMedCrossRef

Antonucci A, Fronzoni L, Cogliandro L, Cogliandro RF, Caputo C, DE Giorgio R, et al. Chronic intestinal pseudo-obstruction. World J Gastroenterol. 2008;14:2953–61.PubMedCrossRef

Nayci A, Avlan D, Polat A, Aksoyek S. Treatment of intestinal pseudo obstruction by segmental resection. Pediatr Surg Int. 2003;19:44–6.PubMedCrossRef

Amiot A, Joly F, Alves A, Panis Y, Bouhnik Y, Messing B. Long-term outcome of chronic intestinal pseudo-obstruction adult patients requiring home parenteral nutrition. Am J Gastroenterol. 2009;104:1262–70.PubMedCrossRef

Mann SD, Debinski HS, Kamm MA. Clinical characteristics of chronic idiopathic intestinal pseudo-obstruction in adults. Gut. 1997;41:675–81.PubMedCrossRef

Lacy BE, Weiser K. Gastrointestinal motility disorders: an update. Dig Dis. 2006;24:228–42.PubMedCrossRef

Gladman MA, Knowles CH. Novel concepts in the diagnosis, pathophysiology and management of idiopathic megabowel. Colorectal Dis. 2008;10:531–8.PubMedCrossRef

Huizinga JD, Thuneberg L, Vanderwinden JM, Rumessen JJ. Interstitial cells of Cajal as targets for pharmacological intervention in gastrointestinal motor disorders. Trends Pharmacol Sci. 1997;18:393–403.PubMed

10.

Boeckxstaens GE, Rumessen JJ, de Wit L, Tytgat GN, Vanderwinden JM. Abnormal distribution of the interstitial cells of cajal in an adult patient with pseudo-obstruction and megaduodenum. Am J Gastroenterol. 2002;97:2120–6.PubMedCrossRef

11.

Murr MM, Sarr MG, Camilleri M. The surgeon’s role in the treatment of chronic intestinal pseudoobstruction. Am J Gastroenterol. 1995;90(12):2147–51.PubMed

12.

Lapointe R. Chronic idiopathic intestinal pseudo-obstruction treated by near total small bowel resection: a 20-year experience. J Gastrointest Surg. 2010;14:1937–42.PubMedCrossRef

13.

Stanghellini V, Cogliandro RF, De Giorgio R, Barbara G, Morselli-Labate AM, Cogliandro L, et al. Natural history of chronic idiopathic intestinal pseudo-obstruction in adults: a single center study. Clin Gastroent Hepatol. 2005;3:449–58.CrossRef

14.

Sigurdsson L, Reyes J, Kocoshis SA, Mazariegos G, Abu-Elmagd KM, Bueno J, et al. Intestinal transplantation in children with chronic intestinal pseudo-obstruction. Gut. 1999;45:570–4.PubMedCrossRef

15.

Lyer K, Kaufman S, Sudan D, Horslen S, Shaw B, Fox I, et al. Long-term results of intestinal transplantation for pseudo-obstruction in children. J Pediatr Surg. 2001;36:174–7.CrossRef

16.

Mittal NK, Tzakis AG, Kato T, Thompson JF. Current status of small bowel transplantation in children: update 2003. Pediatr Clin North Am 2003; 50 ix, 1419–33.

Title: Nationwide survey on adult type chronic intestinal pseudo-obstruction in surgical institutions in Japan
Authors: Tadahiko Masaki
Kenichi Sugihara
Atsushi Nakajima
Tetsuichiro Muto
Publication date: 01-03-2012
Publisher: Springer-Verlag
Published in: Surgery Today / Issue 3/2012
Print ISSN: 0941-1291
Electronic ISSN: 1436-2813
DOI: https://doi.org/10.1007/s00595-011-0115-3

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Nationwide survey on adult type chronic intestinal pseudo-obstruction in surgical institutions in Japan

Abstract

Background

Patients and methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Patients and methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 3/2012

Off-the-job training for VATS employing anatomically correct lung models

Memorial Sloan-Kettering Cancer Center Nomogram to predict the risk of non-sentinel lymph node metastasis in Japanese breast cancer patients

Annuloaortic ectasia treated successfully in a pregnant woman with Marfan syndrome: report of a case

Differences in sensitivity to tumor-specific CTLs between primary and metastatic esophageal cancer cell lines derived from the same patient

Review: single nucleotide polymorphisms associated with the oncogenesis of colorectal cancer

Lung function early after lung transplantation is correlated with the frequency of regulatory T cells