Chronic intestinal pseudo-obstruction: a diagnosis to be considered

Muñoz-Yagüe, M. T.; Solís‐Muñoz, Pablo; Salces, Inmaculada; Ballestı́n, Claudio; Colina, F; Ibarrola, Carolina; López-Alonso, G.; Carreira, Patrícia; Vigo, Felipe de la Cruz; Herruzo, J. A. Solís

doi:10.4321/s1130-01082009000500005

Cited by 16 publications

(15 citation statements)

References 27 publications

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“…12 However, no study has assessed the detailed epidemiology of CIPO, and the prevalence of this intractable disease thus remains unknown. 12 , 24 – 25 Our study is the first nationwide survey of CIPO.…”

Section: Discussionmentioning

confidence: 99%

Epidemiology and Clinical Experience of Chronic Intestinal Pseudo-Obstruction in Japan: A Nationwide Epidemiologic Survey

Iida

Ohkubo

Inamori

et al. 2013

Journal of Epidemiology

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BackgroundWe estimated the prevalence and incidence of chronic intestinal pseudo-obstruction (CIPO) in Japan, investigated the patterns of hospital visits among those with CIPO, and examined present knowledge of CIPO among medical professionals.MethodsA self-administered questionnaire survey was distributed to targeted hospitals throughout Japan, which were selected using stratified random sampling. The questionnaire asked about the number of patients receiving treatment for CIPO, the frequency of their hospital visits, and overall clinical knowledge of CIPO among medical professionals.ResultsCIPO prevalence was estimated to be 1.00 and 0.80 cases per 100 000 males and females, respectively. Incidence was 0.21 and 0.24 cases per 100 000 males and females, respectively. Prevalence and incidence did not significantly differ males and females. Mean age of patients was 63.1 years for males and 59.2 for females. Accurate diagnosis of CIPO sometimes required more than 3 months after initial presentation. Most medical professionals were unaware of or poorly understood CIPO.ConclusionsWe estimated the prevalence and incidence of CIPO in Japan, using data from a nationwide survey. The findings suggest that knowledge of CIPO should be further disseminated so that the disease is not overlooked and is diagnosed without delay.

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Section: Discussionmentioning

confidence: 99%

Epidemiology and Clinical Experience of Chronic Intestinal Pseudo-Obstruction in Japan: A Nationwide Epidemiologic Survey

Iida

Ohkubo

Inamori

et al. 2013

Journal of Epidemiology

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“…28,29 Reaching a correct diagnosis and an effective treatment for patients with chronic abdominal pain of unknown etiology may be frustrating both for the physician and the patient. 30 However, performing a careful evaluation of patient's background, considering thoracic disk herniation (given the high percentage we found in our study), and emphasizing the assessment of symptoms and corresponding examinations-including the useful Carnett sign-may lead the physician to a correct diagnosis. In this way, although screening for visceral disease 31 would still be necessary, a number of expensive investigations could be saved and designing suitable treatments would be easier.…”

Section: Discussionmentioning

confidence: 99%

Thoracic Disk Herniation, a not Infrequent Cause of Chronic Abdominal Pain

Lara¹,

Berges

Quesada³

et al. 2012

International Surgery

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This study assesses the proportion of patients presenting with nonvisceral chronic abdominal pain who have thoracic disk herniation as a possible cause. We designed a descriptive transversal study of patients attending our offices between February 2009 and October 2010, with a complaint of chronic abdominal pain of suspected abdominal wall source (positive Carnett sign). Nuclear magnetic resonance (NMR) of the spinal column was performed on all patients. When the NMR showed thoracic disk herniation the patients were treated according to their etiology. We also evaluated the symptoms in patients with thoracic disk herniation and their response to the applied treatment. Twenty-seven patients with chronic abdominal pain were evaluated. The NMR results in 18 of these 27 patients (66.66%) showed evidence of disk herniation. We report on the results of these 18 patients, emphasizing that the symptoms are florid and varied. Many patients had been previously diagnosed with irritable bowel syndrome. Thoracic disk herniation may account for chronic abdominal pain in many patients who remain undiagnosed or are diagnosed with irritable bowel syndrome. Thus, this possibility needs to be taken into account to achieve a correct diagnosis and a suitable mode of treatment.

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“…The main limitations of this nutritional support include liver insufficiency, pancreatitis, glomerulonephritis and catheter-related complications (septicemia or thrombosis). Primary CIPO due to MNGIE syndrome has a particularly poor prognosis and patients usually die around 40 years of age [17]. …”

Section: Discussionmentioning

confidence: 99%

Emergency surgery in chronic intestinal pseudo-obstruction due to mitochondrial neurogastrointestinal encephalomyopathy: case reports

Castro¹,

Arias²,

Gijón³

et al. 2010

Int Arch Med

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Chronic intestinal pseudo-obstruction (CIPO) is a syndrome characterized by recurrent clinical episodes of intestinal obstruction in the absence of any mechanical cause occluding the gut. There are multiple causes related to this rare syndrome. Mitochondrial neurogastrointestinal encephalomyopathy (MNGIE) is one of the causes related to primary CIPO. MNGIE is caused by mutations in the gene encoding thymidine phosphorylase. These mutations lead to an accumulation of thymidine and deoxyuridine in blood and tissues of these patients. Toxic levels of these nucleosides induce mitochondrial DNA abnormalities leading to an abnormal intestinal motility.Herein, we described two rare cases of MNGIE syndrome associated with CIPO, which needed surgical treatment for gastrointestinal complications. In one patient, intra-abdominal hypertension and compartment syndrome generated as a result of the colonic distension forced to perform emergency surgery. In the other patient, a perforated duodenal diverticulum was the cause that forced to perform surgery. There is not a definitive treatment for MNGIE syndrome and survival does not exceed 40 years of age. Surgery only should be considered in some selected patients.

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Chronic intestinal pseudo-obstruction: a diagnosis to be considered

Cited by 16 publications

References 27 publications

Epidemiology and Clinical Experience of Chronic Intestinal Pseudo-Obstruction in Japan: A Nationwide Epidemiologic Survey

Epidemiology and Clinical Experience of Chronic Intestinal Pseudo-Obstruction in Japan: A Nationwide Epidemiologic Survey

Thoracic Disk Herniation, a not Infrequent Cause of Chronic Abdominal Pain

Emergency surgery in chronic intestinal pseudo-obstruction due to mitochondrial neurogastrointestinal encephalomyopathy: case reports

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