Distal intestinal obstruction syndrome (DIOS) in cystic fibrosis

Case contributed by Dr Natalie Yang


Recent double lung transplant. Now presents with abdominal pain and distension.

Patient Data

Age: 20 years
Gender: Male

CT confirms the presence of a distal small bowel obstruction. The distal small bowel is distended by hyperdense material seen prolapsing from the terminal ileum into the caecum. 

Calcification and pancreatic atrophy in is also noted. 

Bilateral chest drains in situ in keeping with recent lung transplant. Peg tube is no longer in the lumen of the stomach. Nasogastric tube has been inserted. 

Annotated image

Annotated coronal CT

Hyperdense intestinal content protrudes through the ileocecal valve into the caecum (yellow arrow). 

Case Discussion

This case beautifully demonstrates the prolapsing hyperdense bowel content through the ileocecal valve, although to make the diagnosis of DIOS one does not need to see this feature. 

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Case information

rID: 6955
Case created: 30th Aug 2009
Last edited: 6th Feb 2016
Inclusion in quiz mode: Included

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