Distal intestinal obstruction syndrome

Case contributed by Bruno Di Muzio
Diagnosis almost certain

Presentation

Abdominal pain and distention. Background of previous bowel surgery.

Patient Data

Age: 40 years
Gender: Female

Abdomen and pelvis

ct

There is small bowel dilatation with air-fluid levels and fecaloid content becoming progressively dryer from towards the distal ileum with a progressive transition to normal caliber distal ileus. 

Case Discussion

This patient has also a known background history of cystic fibrosis.

Although this patient is at risk for adhesions related bowel obstruction, the lack of a sudden transition point to collapsed bowel and the presence of impacted feces in the distal small bowel and proximal colon, in the setting of known cystic fibrosis, favor distal intestinal obstruction syndrome (DIOS)

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