GASTROGRAFFIN USE IN DISTAL INTESTINAL OBSTRUCTION SYNDROME OF CYSTIC FIBROSIS
Abstract
Background: Meconium ileus equivalent or the Distal Intestinal Obstruction Syndrome (DIOS) isan entity that is frequently seen in patients with cystic fibrosis (CF). In the gastrointestinal tractcystic fibrosis may produces symptoms of malabsorption and constipation. The latter may beassociated with complications such as impaction and intestinal perforation. Meconium ileus andDIOS are an emergency and requires to be treated aggressively to ensure that consequences suchas perforation do not occur. Method: Traditional modes of management of DIOS have includedthe use of laxatives, Acetylcysteine and Gastrograffin enemas. We are describing the use of oralgastrograffin in our patient seen at the Aga Khan University Hospital where small bowelobstruction was refractory to treatment. Oral gastrograffin was used once diluted in 4 times thevolume of water or fruit juice with half doses given on day 2 and 3. Results: Oral gastrograffinuse was followed by relief of obstruction in this patient. Conclusion: Gastrograffin use orally orrectally may be helpful in the treatment of refractions distal intestinal obstruction syndrome incystic fibrosis.Keyword: Gastrograffin, Intestinal, Syndrome, Cystic fibrosisReferences
Rubinstein S, Moss R, Lewiston N. Constipation and
meconium ileus equivalent in patients with cystic fibrosis.
Pediatrics 1986;78(3):473-79.
Millar-Jones L, Goodchild MC. Cystic Fibrosis, pancreatic
sufficiency and distal intestinal obstruction syndrome: a
report of four cases. Acta Paediatr 1995;84(5):577-78
Khoshoo V, Udall JN Jr. Meconium ileus equivalent in
children and adults.Am J Gastroenterol 1994;89(2):153-57
Andersen HO, Hjelt K, Waever E, Overgaard K. The age -
related incidence of meconium ileus equivalent in a cystic
fibrosis population: the impact of high-energy intake. J
Pediatr Gastroenterol Nutr 1990;11(3):356-60
Dray X, Bienvenu T, Desmazes-Dufue N, Dusser D, Marteau
P, Hubert D. Distal Intestinal Obstruction Syndrome in
Adults with Cystic Fibrosis. Clin Gastroenterol Hepatol
;2(6):498-503.
Koletzko S, Stringer DA, Cleghorn GJ, Durie PR. Lavage
treatment of distal intestinal obstruction syndrome in children
with cystic fibrosis. Pediatrics 1989;83(5):727-33
Shah A, Madge S, Dinwiddie R, Habibi P. Hypoglycemia
and Golytely in distal intestinal obstruction syndrome. J R
Soc Med. 1994; 87(2):109-10
Burke MS, Ragi JM, Karamanoukian HL, Kotter M, Brisseau
GF, Borowitz DS et al. New strategies in nonoperative
management of mecoinum ileus. J Pediatr Surg.
;37(5):760-4.
Kao SC, Franken EA. Nonoperative treatment of simple
meconium ileus: a survey of the Society for Pediatric
Radiology.Pediatr Radiol. 1995;25(2):97-100.
Zentler-Munro PL. Cystic fibrosis--a gastroenterological
cornucopia. Gut. 1987;28(11):1531-47.
Hypaque package insert (Winthrop, US). In: PDR Physicians'
desk reference. 36th ed. 1982. Oradell, NJ: Medical
Economics Company, 1982: 3019, 3043-59.
McEvoy GK, editor. AHFS Drug information 91. Bethesda,
MD: American Society of Hospital Pharmacists, 1991: 858,
Cohen MD. Choosing contrast media for pediatric
gastrointestinal examinations. Crit Rev Diagn Imaging 1990;
(4): 317-40.
Poole CA, Rowe MI. Clinical evidence of intestinal
absorption of Gastrografin. Radiology. 1976; 118(1): 151-3.
Swanson DP, Chilton HM, Thrall JH, editors.
Pharmaceuticals in medical imaging. New York: Macmillan
Publishing Company, 1990: 1-35, 42, 95-97, 166, 253-77.
Manufacturer Drug Information. Hypaque Meglumine 30%
package insert (Winthrop-US), Rev 4/89.
Manufacturer Drug Information. Hypaque sodium oral
solution package insert (Sanofi Winthrop-US), Rev 6/92, Rev
/93.
O'Halloran SM, Gilbert J, McKendrick OM, Carty HM, Heaf
DP. Gastrografin in acute meconium ileus equivalent. Arch
Dis Child. 1986; 61(11):1128-30.
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