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dc.contributor.authorAlattar, Zana
dc.contributor.authorThornley, Caitlin
dc.contributor.authorBehbahaninia, Milad
dc.contributor.authorSisley, Amy
dc.date.accessioned2019-10-10T20:03:25Z
dc.date.available2019-10-10T20:03:25Z
dc.date.issued2019-09-13
dc.identifier.citationAlattar, Z., Thornley, C., Behbahaninia, M., & Sisley, A. (2019). Proximal small bowel obstruction in a patient with cystic fibrosis: a case report. Surgical case reports, 5(1), 143.en_US
dc.identifier.issn2198-7793
dc.identifier.pmid31520190
dc.identifier.doi10.1186/s40792-019-0701-y
dc.identifier.urihttp://hdl.handle.net/10150/634746
dc.description.abstractBackground As advancements are made in the management of cystic fibrosis (CF), survival of the CF patient into adulthood has increased, leading to the discovery of previously unknown CF complications. Though gastrointestinal complications of CF, such as distal intestinal obstruction syndrome, are common, this case demonstrates a variant presentation of small bowel obstruction in this population. Case presentation We describe a 42-year-old male with CF who presented with 2 days of worsening upper abdominal pain, emesis, and loss of bowel function. The patient had no history of any prior abdominal surgeries; however, imaging was concerning for high-grade mechanical small bowel obstruction possibly related to internal hernia. Given leukocytosis and diffusely tender abdomen found on further workup, the decision was made to proceed with diagnostic laparoscopy after a brief period of intravenous fluid resuscitation. Intraoperatively, the transition point was found in the mid-jejunum and was noted to be due to kinking of the bowel causing vascular congestion in the proximal portion. Surgical manipulation of the bowel was required for return of normal perfusion and patency. Conclusion Though the exact mechanism cannot be definitively delineated, we speculate that the increased viscosity and prolonged intestinal transit time, characteristic of CF, resulted in inspissated fecal content in the proximal small bowel, which then acted as a lead point for obstruction. Thus, though small bowel obstruction in patients with CF is often attributed to distal intestinal obstruction syndrome, a broader differential must be considered. Early surgical intervention may be necessary to prevent bowel ischemia and subsequent small bowel resection in a patient presenting with concerning clinical and image findings, as was seen in this patient.en_US
dc.language.isoenen_US
dc.publisherSPRINGEROPENen_US
dc.rightsCopyright © The Author(s). 2019 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.en_US
dc.subjectAbdominal painen_US
dc.subjectCystic fibrosisen_US
dc.subjectDistal intestinal obstruction syndromeen_US
dc.subjectSmall bowel obstructionen_US
dc.subjectSurgical managementen_US
dc.titleProximal small bowel obstruction in a patient with cystic fibrosis: a case reporten_US
dc.typeArticleen_US
dc.contributor.departmentUniv Arizona, Coll Med, Phoenix Integrated Surg Residencyen_US
dc.contributor.departmentUniv Arizona, Coll Meden_US
dc.identifier.journalSURGICAL CASE REPORTSen_US
dc.description.noteOpen access journalen_US
dc.description.collectioninformationThis item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at repository@u.library.arizona.edu.en_US
dc.eprint.versionFinal published versionen_US
dc.source.journaltitleSurgical case reports
refterms.dateFOA2019-10-10T20:03:25Z


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