J Neurogastroenterol Motil.  2017 Apr;23(2):273-280. 10.5056/jnm16101.

Chronic Intestinal Pseudo-obstruction: Clinical and Manometric Characteristics in the Chilean Population

• de Arce EP
• Landskron
• Hirsch S
• Defilippi
• Madrid AM

• KMID: 2433528
• DOI: http://doi.org/10.5056/jnm16101

Abstract

BACKGROUND/AIMS
Chronic intestinal pseudo-obstruction (CIPO) is a rare syndrome characterized by a failure of the propulsion of intraluminal contents and recurrent symptoms of partial bowel obstruction in the absence of mechanical obstruction. Regional variations of the intestinal compromise have been described. Intestinal manometry can indicate the pathophysiology and prognosis. Our objective is to establish the demographic and clinical characteristics of group Chilean patients and analyze the motility of the small intestine and its prognostic value.
METHODS
Patients with symptoms of intestinal pseudo-obstruction with dilated bowel loops were included, in all of whom a manometry of the small intestine was performed using perfused catheters.
RESULTS
Of the 64 patients included, 51 women (average age 41.5 ± 17.6 years), 54 primary and 10 secondary CIPO were included. Dilatation of the small intestine was the only finding in 38 patients; in the remaining, the compromise was associated with other segments, primarily the colon. Forty-nine patients underwent 65 surgeries, mainly exploratory laparotomies and colectomies. Intestinal manometry was performed on all patients; 4 "patterns" were observed: neuropathic (n = 26), myopathic (n = 3), mixed (n = 24), and a group without motor activity (n = 11). The most relevant findings were the complex migrating motor disorders and decreased frequency and propagation of contractions. The 9 patients who died had a severe myopathic compromise.
CONCLUSIONS
In our series, isolated small bowel compromise was the most common disorder. Neuropathic motor compromise was observed in most of the patients. Mortality was associated with severe myopathic compromise.

Keyword

Intestinal pseudo-obstruction; Manometry; intestinal obstruction; Myoelectric complex; Small intestine

MeSH Terms

Catheters
Colectomy
Colon
Dilatation
Female
Humans
Intestinal Obstruction
Intestinal Pseudo-Obstruction*
Intestine, Small
Laparotomy
Manometry
Mortality
Motor Activity
Motor Disorders
Prognosis