{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T04:24:01Z","timestamp":1777695841224,"version":"3.51.4"},"reference-count":13,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2013,11,18]],"date-time":"2013-11-18T00:00:00Z","timestamp":1384732800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ANZ Journal of Surgery"],"published-print":{"date-parts":[[2014,10]]},"abstract":"Abstract<\/jats:title>Background<\/jats:title>Cystic fibrosis (CF<\/jats:styled-content>) can result in distal intestinal obstruction syndrome (DIOS<\/jats:styled-content>) due to inspissated mucus. This paper describes the clinicopathological characteristics of adult CF<\/jats:styled-content> patients with DIOS<\/jats:styled-content> and assesses risk factors for surgery.<\/jats:p><\/jats:sec>Methods<\/jats:title>A retrospective audit of CF<\/jats:styled-content> patients at the Alfred Hospital from J<\/jats:styled-content>anuary 2007 to F<\/jats:styled-content>ebruary 2012 was carried out. Patients who had \u2018bowel obstruction or constipation\u2019 were abstracted from the database, and medical records were reviewed for a diagnosis of DIOS<\/jats:styled-content>.<\/jats:p><\/jats:sec>Results<\/jats:title>Forty\u2010five encounters of 35 patients were extracted. Twenty\u2010five (83%) patients were homozygous for the delta F<\/jats:styled-content>508 mutations, 29 (85%) had pancreatic insufficiency and 15 (44%) had a lung transplant. Patients presented with abdominal pain (96% of encounters), nausea (76% of encounters) and vomiting (67% of encounters). Computed tomography (CT<\/jats:styled-content>) was performed in 20 episodes. Compared with CT<\/jats:styled-content>, abdominal X<\/jats:styled-content>\u2010ray had a sensitivity of 63% (95% confidence interval (CI<\/jats:styled-content>) 30\u201389%) and specificity of 33% (95% CI<\/jats:styled-content> 8\u201370%) for detecting DIOS<\/jats:styled-content> with obstruction. Forty\u2010one (91%) encounters resolved with medical management within 2\u20133 days. Three patients required surgical intervention in four episodes. Previous laparotomy (odds ratio (OR<\/jats:styled-content>) 28.5, 95% CI<\/jats:styled-content> 1.3\u2013624, P<\/jats:italic> = 0.03) and history of meconium ileus (OR<\/jats:styled-content> 14, 95% CI<\/jats:styled-content> 1\u2013192, P<\/jats:italic> < 0.05) were statistically significant predictors of progression to surgical management.<\/jats:p><\/jats:sec>Conclusion<\/jats:title>In most patients with DIOS<\/jats:styled-content>, the obstruction resolves with medical management. Early consultation with a CF<\/jats:styled-content> service, assessment for a surgical abdomen and involvement of surgeons where appropriate is recommended. A history of previous laparotomy is a risk factor for the need for surgical intervention.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ans.12397","type":"journal-article","created":{"date-parts":[[2013,11,18]],"date-time":"2013-11-18T12:16:02Z","timestamp":1384776962000},"page":"740-744","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Distal intestinal obstruction syndrome in cystic fibrosis: presentation, outcome and management in a tertiary hospital (2007\u20132012)"],"prefix":"10.1111","volume":"84","author":[{"given":"Rami","family":"Subhi","sequence":"first","affiliation":[{"name":"Department of Colorectal Surgery Alfred Health Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rachel","family":"Ooi","sequence":"additional","affiliation":[{"name":"Monash University Medical School Monash University Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Felicity","family":"Finlayson","sequence":"additional","affiliation":[{"name":"Cystic Fibrosis Service Department of Allergy, Immunology and Respiratory Medicine Alfred Health Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tom","family":"Kotsimbos","sequence":"additional","affiliation":[{"name":"Cystic Fibrosis Service Department of Allergy, Immunology and Respiratory Medicine Alfred Health Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Wilson","sequence":"additional","affiliation":[{"name":"Cystic Fibrosis Service Department of Allergy, Immunology and Respiratory Medicine Alfred Health Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wei Ran","family":"Lee","sequence":"additional","affiliation":[{"name":"Monash University Medical School Monash University Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roger","family":"Wale","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery Alfred Health Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Satish","family":"Warrier","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery Alfred Health Melbourne Victoria Australia"},{"name":"Division of Cancer Surgery Peter MacCallum Cancer Institute Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2013,11,18]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/adc.77.6.493"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1542-3565(04)00169-7"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005176-199010000-00012"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/MPG.0b013e3181a6e01d"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.128.4.2309"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1569-1993(11)60005-2"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.143.6.601"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiographics.16.4.8835977"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11605-009-0924-5"},{"key":"e_1_2_7_11_1","unstructured":"PeckhamD MortonA.Treatment of Distal Intestinal Obstruction Syndrome 2003. 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