AN UNUSUAL CAUSE OF BOWEL OBSTRUCTION

Background: Although gastrointestinal issues and bowel blockages can appear at any age in individuals with cystic fibrosis (CF), acute intestinal obstructions after the neonatal stage are relatively rare. Distal intestinal obstruction syndrome (DIOS) is more likely to develop in cystic fibrosis patients who have pancreatic insufficiency, a prior history of meconium ileus, or previous episodes of DIOS.

Case Presentation: A 15-month-old female patient diagnosed case of Cystic fibrosis was admitted with complaints of constipation and abdominal distension for 3 days, with a history of undocumented fever, associated with non-biliousvomitings. On examination: the abdomen was soft and distended, and a mass in RIF could be palpated, the Rest of the General physical and systemic examinations were unremarkable. Initial abdominal X-rays showed persistent fecal impaction in the caecal region. The patient underwent a Gastrografin enema that relieved the obstruction partially, The Gastrografin enema repeated after 2 days resolved the obstruction completely.

Conclusion:Distal intestinal obstruction syndrome (DIOS) is a recognized complication of cystic fibrosis. It results from the accumulation of viscid fecal matter mixed with thick, sticky intestinal mucus. This mixture typically adheres to the intestinal wall—most often in the terminal ileum and caecum—causing a fixed, difficult-to-resolve obstruction.Once DIOS is diagnosed, the primary objective is prompt relief of the obstruction. Medical treatments, including osmotic contrast enemas such as Gastrografin, are often effective. Surgical intervention is generally reserved for refractory cases due to its high post-operative morbidity.