II. Epidemiology

  1. Incidence
    1. Occurs in up to 10 to 22% of Cystic Fibrosis patients

III. Mechanism

  1. Small Bowel Obstruction in the ileocecal region in Cystic Fibrosis patients
  2. Triggered by pancreatic insufficiency, dysmotility and Dehydration

IV. Findings

  1. Presents with Right lower quadrant mass

V. Differential Diagnosis

  1. Constipation
  2. Other Small Bowel Obstruction
  3. Volvulus
  4. Intussception
  5. Fibrosing Colonopathy
  6. Appendicitis
  7. Crohns Disease
  8. Malignancy

VI. Imaging

  1. CT Abdomen (first line study)
    1. Diagnostic for Distal Intestinal Obstruction
    2. Evaluates differential diagnosis
  2. Abdominal XRay
    1. Demonstrates obstructive findings, but CT Abdomen is typically required

VII. Management

  1. Incomplete Obstruction
    1. Nonsurgical management
    2. Oral rehydration
    3. Enemas, Osmotic Laxatives and Stool Softeners
    4. Consider osmotic contrast
  2. Complete Obstruction
    1. Nasogastric Tube decompression
    2. Laparotomy with manual decompression of obstruction

VIII. Complications

IX. References

  1. Uddin and Crawford (2023) Crit Dec Emerg Med 37(9): 15-5
  2. Colombo (2011) J Cyst Fibros 10(suppl 2): 524-8 [PubMed]

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Related Studies

Ontology: Distal intestinal obstruction syndrome (C0398349)

Concepts Disease or Syndrome (T047)
ICD10 E84.19
SnomedCT 233662009
English DIOS-Dist intest obstr syndrom, Dist intest obstr syndrome, MIE - Meconium ileus equiv, Meconium ileus equivalent syndrome, DIOS - Distal intestinal obstruction syndrome, Distal intestinal obstruction syndrome, MIE - Meconium ileus equivalent, Meconium ileus equivalent, Distal intestinal obstruction syndrome (disorder)
Italian Sindrome da ostruzione distale dell'intestino, Sindrome equivalente dell'ileo da meconio
Dutch meconiumileus equivalent-syndroom, distaal intestinaal obstructiesyndroom
German Meconium ileus-artiges Syndrom, Distales intestinales Obstruktionssyndrom
Portuguese Síndrome equivalente a íleus meconial, Síndrome de obstrução intestinal distal
Spanish Síndrome semejante al íleo meconial, síndrome de obstrucción intestinal distal (trastorno), síndrome de obstrucción intestinal distal, Síndrome de obstrucción intestinal distal
Japanese 胎便イレウス様症候群, 末端腸閉塞症候群, タイベンイレウスヨウショウコウグン, マッタンチョウヘイソクショウコウグン
French Syndrome équivalent de l'iléus méconial, Syndrome d'obstruction de l'intestin distal
Czech Syndrom distální střevní obstrukce, Syndrom odpovídající mekoniovému ileu
Hungarian Meconium ileus equivalens syndroma, Intestinalis distalis obstructio syndroma