Review
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Dec 6, 2020; 8(23): 5852-5865
Published online Dec 6, 2020. doi: 10.12998/wjcc.v8.i23.5852
Latest developments in chronic intestinal pseudo-obstruction
Chang-Zhen Zhu, Hong-Wei Zhao, Hong-Wei Lin, Feng Wang, Yuan-Xin Li
Chang-Zhen Zhu, Hong-Wei Zhao, Hong-Wei Lin, Feng Wang, Yuan-Xin Li, Department of Gastrointestinal Surgery, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing 102218, China
Author contributions: Li YX provided design and guidance; Zhu CZ consulted the literature and completed the writing; Zhao HW, Lin HW and Wang F assisted in the literature review.
Supported by the Initial Scientific Research Fund of Young of Beijing Tsinghua Changgung Hospital, No. 12020C1003.
Conflict-of-interest statement: There is no conflict of interest for all authors in this paper.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yuan-Xin Li, MD, Chief Doctor, Professor, Surgeon, Department of Gastrointestinal, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, No. 168 Litang Road, Changping District, Beijing 102218, China. liyuanxin1966@163.com
Received: March 6, 2020
Peer-review started: March 6, 2020
First decision: May 29, 2020
Revised: October 2, 2020
Accepted: October 19, 2020
Article in press: October 19, 2020
Published online: December 6, 2020
Processing time: 272 Days and 21 Hours
Abstract

Chronic intestinal pseudo-obstruction (CIPO) is a type of intestinal dysfunction presenting as symptoms of intestinal obstruction but without actual mechanical obstruction. An extremely low incidence, non-specific clinical symptoms, strong heterogeneity, and no definitive cause in some patients make CIPO very difficult to diagnose correctly. Imaging and gastrointestinal manometry are commonly used. Most patients have progressive worsening of their symptoms and require intervention, and nutritional assessment and treatment are very important to determine the prognosis. With improvements in surgical techniques, small bowel transplantation is a feasible treatment option for patients with advanced CIPO; however, the long-term prognosis for CIPO patients remains unsatisfactory. Generally, the disease is rare and difficult to diagnose, which leads to clinicians’ lack of understanding of the disease and results in a high rate of misdiagnosis. This review describes the characteristics of CIPO and the latest developments in diagnosis and treatment, in detail. The goal of our review is to improve clinicians' understanding of CIPO so that the disease is identified quickly and accurately, and treated as early as possible to improve patients’ quality of life.

Keywords: Chronic intestinal pseudo-obstruction; Intestinal obstruction; Enteral nutrition; Parenteral nutrition; Intestinal transplantation

Core Tip: Chronic intestinal pseudo-obstruction (CIPO) is an intestinal motility disorder caused by neuropathies, myopathies, and mesenchymopathies. CIPO is very difficult to diagnose correctly, leading to most patients experiencing several years from symptom onset to diagnosis. The high misdiagnosis rate relates not only to the characteristics of CIPO itself, but also to the lack of clinicians’ understanding of the disease. Using published studies, we systematically summarized the diagnosis, treatment, and other information related to CIPO to help clinicians recognize this disease early and minimize patients’ suffering.