Surgical Treatment of Chronic Intestinal Pseudo-Obstruction: Report of Three Cases

Abstract

We report the cases of three patients with chronic intestinal pseudo-obstruction (CIP) whose quality of life (QOL) was improved by palliative surgery in combination with home parenteral nutrition (HPN). Loop enterostomy and shortening of the gastrointestinal tract was performed with good results in all three patients to relieve abdominal distension that was progressive despite treatment with prokinetic drugs. Oral intake was also improved after surgical treatment in one patient who underwent massive resection of the jejunoileum. HPN maintained a satisfactory nutritional state in all patients. These three case reports serve to demonstrate that surgical intervention to improve QOL should be considered for patients with CIP if medication is not effective and symptoms are progressive.

Non‐transplantation surgical approach for chronic intestinal pseudo‐obstruction: analysis of 63 adult consecutive cases

“…[21][22][23] The first case-series from our group, described five CIPO patients with a median remnant small bowel length of 15 (10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20) cm) with jejunocolonic anastomosis. Postoperative complications occurred in two-third of the cases and one patient died postoperatively of anastomotic leakage.…”

Review article: the assessment and management of chronic severe gastrointestinal dysmotility in adults

“…In one case report, a lower jejunal stoma and intestinal fistula were created in a patient with CIPO for periodic small bowel washing with an anti‐bacterial solution for refractory SIBO . Loop enterostomy and shortening of the GI tract were employed palliatively in combination with HPN in three patients …”

Hand-assisted laparoscopic subtotal colectomy with cecorectal anastomosis for chronic idiopathic colonic pseudo-obstruction: report of a case

“…CIIP, on the other hand, does not require surgery, but instead is treated with medications such as prokinetics (8,9) or nutritional support such as central venous nutrition (10) or home parenteral nutrition (11). In some cases, palliative surgery has been performed and improved the quality of life of patients with CIIP (12,13). However, surgical intervention is not a curative treatment option for CIIP patients, and the benefit is likely temporary.…”