Nationwide survey on adult type chronic intestinal pseudo-obstruction in surgical institutions in Japan

Abstract

Background

No appropriate management of chronic intestinal pseudo-obstruction (CIP) has been established.

Patients and methods

The clinicopathological parameters of 103 cases collected by a nationwide questionnaire study were reviewed.

Results

The CIP cases were primary in 86 (83%) cases and secondary in 15 (15%) cases. The age of onset of the primary type was significantly younger than that of the secondary type (p = 0.011). The diseased segments of the bowel were the large bowel in 60 (58%), the small bowel in 17 (17%), and both in 23 (22%) cases, respectively. Abdominal distension and pain were common symptoms regardless of the types of the diseased bowel; however, constipation was frequently seen in the large bowel type (p = 0.0258). Vomiting and diarrhea were seen with marginally higher frequency in the small bowel type (p = 0.0569, 0.0642). Surgical treatment was most effective in the large bowel type, less effective in the small bowel type, and least effective in the large and small bowel type. The prognosis of the primary CIP was significantly better than that of the secondary CIP (p = 0.033).

Conclusions

The segments of the diseased bowels should be considered in determining the indications for surgical treatments in CIP patients.

Appendix

The following surgeons contributed to patient enrollment in this study: Tomoo Shatari, MD (Japanese Red Cross Mito Hospital); Nobumichi Takeuchi, MD (Ina Central Hospital); Kazuhiro Sakamoto, MD (Juntendo University); Masato Kusunoki, MD (Mie University); Kazutaka Narii, MD (Saiseikai Yokohamashi Nanbu Hospital); Tetsuro Higuchi, MD (Tokyo Medical and Dental University); Kazuhiko Yoshimatsu, MD (Tokyo Women’s Medical University Medical Center East); Norio Saito, MD (National Cancer Center East); Tomohisa Furuhata MD (Sapporo Medical University); Takanobu Sugase, MD (Koga General Hospital); Kenji Nakagawa, MD (Nakagawa Geka-Ichoka Hospital); Kazuo Hase, MD (National Defense Medical College); Masafumi Inomata, MD (Oita University); Shodo Sakai, MD (Nozaki Tokushukai Hospital); Takayuki Ogino, MD and Hirofumi Ota, MD (Osaka Saiseikai Senri Hospital); Yoshihisa Shibata, MD (Toyohashi Municipal Hospital); Shintaro Akamoto, MD (Kagawa University); Toshimitsu Toyohara, MD (Fukunishikai Hospital); Kazuhiko Yoshioka, MD (Kansai Medical University); Junichi Tanaka, MD (Showa University Northern Yokohama Hospital); Hideo Watanabe, MD (Watanabe Hospital); Tsuneo Iiai, MD (Niigata University); Isao Hirayama, MD (Saiseikai Maebashi Hospital); Masaru Udagawa, MD (Toride Kyodo General Hospital); Tetsuya Kobayashi, MD (Jikei University School of Medicine); Kimiharu Mikami, MD (Fukuoka University Chikushi Hospital); Hiroshi Iino, MD (Yamanashi University); Nagahide Matsubara, MD (Hyogo College of Medicine); Yoshio Ushirokouji, MD (Tokyo Kyosai Hospital); Kazuhiro Toyoda, MD (Higashihiroshima Medical Center); Masayuki Node, MD (Takaoka Municipal Hospital); Osamu Kimura, MD (Yonago Medical Center); Kunio Takeuchi, MD (Tone Chuou Hospital); Riichiro Nezu, MD (Osaka Rosai Hospital); Yasuyo Ishizaki, MD (JA Onomichi General Hospital); Toshiharu Umemoto, MD and Satoshi Arakawa, MD (Fujita Health University Banbuntane Hotokukai Hospital); Seiichiro Shida, MD (Shimada Hospital); Kiyoshi Maeda, MD (Osaka City University); Mitsuyoshi Ota, MD (Yokohama City University); Heita Ozawa, MD (Kitasato University); Yasuhisa Yokoyama, MD and Tadashi Yokoyama, MD (Yokoyama Gastroenterogical Hospital); Hisanaga Horie, MD (Jichi Medical University); Nobuhiro Nitori, MD (International University of Health and Welfare Mita Hospital); Hidekazu Oishi, MD (Ishinomaki Municipal Hospital); Hideki Yamakoshi, MD (Kouhoku Koumon Clinic); Shoichi Hazama, MD (Yamaguchi University); Hironori Samura, MD (Ryukyu University); Fumio Tokumine, MD (Asato Daicho-Koumon Clinic); Eisuke Kondo, MD (Japanese Red Cross Narita Hospital); Michinaga Takahashi, MD (South Miyagi Medical Center); Toru Kono, MD (Asahika Medical University); Yoshihiko Takao, MD (Sanno Hospital); Miyoji Wakabayashi, MD (Hokusoushiroi Hospital); Shusaku Yoshikawa, MD (Kenseikai Nara Dongo Hospital); Chikashi Shibata, MD (Tohoku University)