Clinical characteristics of chronic intestinal pseudo-obstruction: an analysis of 43 cases

Objective To analyze the clinical characteristics of chronic intestinal pseudo-obstruction (CIPO). Methods Clinical data of 43 patients with CIPO admitted in Peking Union Medical College Hospital from January 2012 to December 2016 were retrospectively reviewed. The clinical manifestations, laboratory examinations, images, treatment and prognosis of CIPO patients were analyzed. Results There were 14 males and 29 females with an mean age of (41.9±16.1)years. Among 43 patients, 32 were admitted in Gastroenterology Department, 6 in General Medicine Department and 5 in Rheumatology Department. Twenty two cases were primary CIPO and 21 cases were secondary. The main clinical manifestations were abdominal distension (93.0%), abdominal pain (67.4%), vomiting (67.4%), diarrhea (46.5%) and constipation (41.9%). All 43 patients had decreased body weight and body mass index (BMI); 23.3% (10/43) patients were complicated with anxiety and depression. 53.5% (23/43) patients presented anemia and 55.8% (24/43) patients presented hypoalbuminemia. All patients with CIPO underwent abdominal X-ray, which showed intestinal obstruction; but there was no evidence of mechanical obstruction. The average length of hospital stay was (28.4±13.9) d. Twenty three cases underwent gastric decompression; 28 cases (65.1%) received parenteral nutrition, and 21 cases (48.8%) received enteral nutrition; and 9 abdominal operations were performed in 8 patients. Conclusion When clinical symptoms of intestinal obstruction appear without mechanical cause, CIPO should be considered and secondary factors should be screened. Unnecessary surgery should be avoided in CIPO patients. Key words: Intestinal pseudo-obstruction; Disease attributes; Chronic