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Chronic Idiopathic Intestinal Pseudo-obstruction Treated by Near Total Small Bowel Resection: A 20-Year Experience

  • Original Article
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Journal of Gastrointestinal Surgery Aims and scope

Abstract

Background

Patients suffering from chronic idiopathic intestinal pseudo-obstruction (CIIPO) clearly benefit from home parenteral nutrition (HPN) to maintain adequate nutritional status and general health. But intestinal dismotility can seriously disturb their quality of life (QOL) to the point of making it intolerable.

Aim

Report our clinical experience on the management of chronic severe occlusive symptoms in CIIPO by near total small bowel resection.

Methods

A 20-year retrospective study of eight patients with end-stage CIIPO maintained on HPN and suffering of chronic occlusive symptoms refractory to medical treatment underwent extensive small bowel resection preserving less than 70 cm of total small bowel and less than 20 cm of ileum. The jejunum was anastomosed either to the ileum or to the colon.

Results

Six patients were completely relieved from obstructive symptoms. Two patients needed a second operation to remove the residual ileum because of recurrent symptoms. Two were significantly improved. There was no post-operative death. All patients experienced a significant improvement in their QOL.

Conclusion

Near total small bowel resection appears to be a safe and effective procedure in end-stage CIIPO patients, refractory to optimal medical treatment.

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Abbreviations

CIIPO:

Chronic idiopathic intestinal pseudo-obstruction

HPN:

Home parenteral nutrition

IT:

Intestinal transplantation

QOL:

Quality of life

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Acknowledgments

We wish to thank Dr. Pierre Poitras, Gastroenterologist at the CHUM, Montreal for his expert and continuous help and encouragement in the writing of this paper, and Dr. KN Jeejeebhoy, gastroenterologist at St Michael’s Hospital in Toronto, for his reviewing, advices and encouragement to publish this experience. Thanks also to Dr Luc Belanger MD PhD, director of research laboratory at Hôtel-Dieu de Québec, for his encouragements and suggestions, to Dr Bernard Têtu, pathologist and assistant director of clinical research, Laval University, for his advices, and to Dr Steven Lapointe for the final corrections and his invaluable help in the redaction of this manuscript.

Conflicts of interest

None

Writing assistance

Dr. Pierre Poitras, Dr. Kursheed N Jeejeebhoy, Dr Luc Belanger MD PhD, Dr Bernard Têtu, Dr Steven Lapointe.

Funding

None

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Authors and Affiliations

  1. Department of Surgery, Hôtel-Dieu de Québec, Centre Hospitalier Universitaire de Québec, Université Laval, Québec, Canada

    Roch Lapointe

  2. 40, du Faubourg, St-Ferréol-les-Neiges, Quebec, G0A 3R0, Canada

    Roch Lapointe

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  1. Roch Lapointe
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Correspondence to Roch Lapointe.

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Lapointe, R. Chronic Idiopathic Intestinal Pseudo-obstruction Treated by Near Total Small Bowel Resection: A 20-Year Experience. J Gastrointest Surg 14, 1937–1942 (2010). https://doi.org/10.1007/s11605-010-1295-7

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  • DOI: https://doi.org/10.1007/s11605-010-1295-7

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