EURORAD ESR

Case 15404

Distal intestinal obstruction syndrome (DIOS) in cystic fibrosis

Author(s)
Tonolini Massimo, M.D.; Petullà Marina, M.D.

"Luigi Sacco" University Hospital, Radiology Department; Via G.B. Grassi 74 20157 Milan, Italy; Email:mtonolini@sirm.org
 
Patient
male, 39 year(s)
 
 
  • Figure 1
    Plain abdominal radiographs
     

    Supine (a) and upright (b) radiographs showed marked gaseous dilatation of entire small bowel, fecaloid content in the distal ileum (*), several air-fluid levels (thin arrows) suggesting obstruction. Note empty colon,...

     
    Area of Interest: Small bowel; Imaging Technique: Plain radiographic studies; Procedure: Diagnostic procedure; Special Focus: Obstruction / Occlusion;

    Supine (a) and upright (b) radiographs showed marked gaseous dilatation of entire small bowel, fecaloid content in the distal ileum (*), several air-fluid levels (thin arrows) suggesting obstruction. Note empty colon,...

     
    Area of Interest: Small bowel; Imaging Technique: Plain radiographic studies; Procedure: Diagnostic procedure; Special Focus: Obstruction / Occlusion;
     
     
  • Figure 2
    Pre- and post-contrast multidetector CT
     

    Unenhanced images (a,b) showed distended abdomen caused by diffusely dilated small bowel with fecaloid content (*) and air-fluid levels (thin arrows); collapsed colon with some faeces in caecum (* in a).

     
    Area of Interest: Small bowel; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Obstruction / Occlusion;

    Unenhanced images (a,b) showed distended abdomen caused by diffusely dilated small bowel with fecaloid content (a) and air-fluid levels (thin arrows), collapsed colon with some faeces in the caecum. No ascites and...

     
    Area of Interest: Small bowel; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Obstruction / Occlusion;

    Post-contrast acquisition (c...g) confirmed dilated entire small bowel with air-fluid levels (thin arrows), fecaloid content (*) becoming progressively dryer from the jejunum to the distal ileum. Collapsed colon with...

     
    Area of Interest: Small bowel; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Obstruction / Occlusion;

    Post-contrast acquisition (c...g) confirmed dilated entire small bowel with air-fluid levels (thin arrows), fecaloid content (*) becoming progressively dryer from the jejunum to the distal ileum.

     
    Area of Interest: Small bowel; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Obstruction / Occlusion;

    Post-contrast acquisition (c...g) confirmed dilated entire small bowel with air-fluid levels (thin arrows), fecaloid content (*) becoming progressively dryer from the jejunum to the distal ileum.

     
    Area of Interest: Small bowel; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Obstruction / Occlusion;

    Coronal reconstructions (f,g) confirmed dilatation of entire small bowel with fecaloid content (*) becoming progressively dryer from the jejunum to the distal ileum. Collapsed colon with some faeces in caecum.

     
    Area of Interest: Small bowel; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Obstruction / Occlusion;

    Coronal reconstructions (f,g) confirmed dilatation of entire small bowel with fecaloid content (*) becoming progressively dryer from the jejunum to the distal ileum. Collapsed colon with some faeces in caecum.

     
    Area of Interest: Small bowel; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Obstruction / Occlusion;
     
     
  • Figure 3
    Plain abdominal radiographs after treatment (48 hours after Fig.1)
     

    After medical therapy, repeated supine (a) and upright (b) radiographs showed near-complete resolution of obstructive changes shown in Fig.1.

     
    Area of Interest: Small bowel; Imaging Technique: Plain radiographic studies; Procedure: Diagnostic procedure; Special Focus: Obstruction / Occlusion;

    After medical therapy, repeated supine (a) and upright (b) radiographs showed near-complete resolution of obstructive changes shown in Fig.1.

     
    Area of Interest: Small bowel; Imaging Technique: Plain radiographic studies; Procedure: Diagnostic procedure; Special Focus: Obstruction / Occlusion;
     
     
Supine (a) and upright (b) radiographs showed marked gaseous dilatation of entire small bowel, fecaloid content in the distal ileum (*), several air-fluid levels (thin arrows) suggesting obstruction. Note empty colon, apart from minimal caecal air.
 
Supine (a) and upright (b) radiographs showed marked gaseous dilatation of entire small bowel, fecaloid content in the distal ileum (*), several air-fluid levels (thin arrows) suggesting obstruction. Note empty colon, apart from minimal caecal air.
 
Unenhanced images (a,b) showed distended abdomen caused by diffusely dilated small bowel with fecaloid content (*) and air-fluid levels (thin arrows); collapsed colon with some faeces in caecum (* in a).
 
Unenhanced images (a,b) showed distended abdomen caused by diffusely dilated small bowel with fecaloid content (a) and air-fluid levels (thin arrows), collapsed colon with some faeces in the caecum. No ascites and pneumoperitoneum.
 
Post-contrast acquisition (c...g) confirmed dilated entire small bowel with air-fluid levels (thin arrows), fecaloid content (*) becoming progressively dryer from the jejunum to the distal ileum. Collapsed colon with some faeces in caecum (*).
 
Post-contrast acquisition (c...g) confirmed dilated entire small bowel with air-fluid levels (thin arrows), fecaloid content (*) becoming progressively dryer from the jejunum to the distal ileum.
 
Post-contrast acquisition (c...g) confirmed dilated entire small bowel with air-fluid levels (thin arrows), fecaloid content (*) becoming progressively dryer from the jejunum to the distal ileum.
 
Coronal reconstructions (f,g) confirmed dilatation of entire small bowel with fecaloid content (*) becoming progressively dryer from the jejunum to the distal ileum. Collapsed colon with some faeces in caecum.
 
Coronal reconstructions (f,g) confirmed dilatation of entire small bowel with fecaloid content (*) becoming progressively dryer from the jejunum to the distal ileum. Collapsed colon with some faeces in caecum.
 
After medical therapy, repeated supine (a) and upright (b) radiographs showed near-complete resolution of obstructive changes shown in Fig.1.
 
After medical therapy, repeated supine (a) and upright (b) radiographs showed near-complete resolution of obstructive changes shown in Fig.1.
 
 
 
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