Successful treatment of distal intestinal obstruction syndrome with N-acetylcysteine and polyethylene glycol via colonoscopy

Ikenna K Emelogu; Cynthia N Tran; Wendy R Greene; Joshua D Novak

doi:10.1016/j.jcf.2023.06.014

Successful treatment of distal intestinal obstruction syndrome with N-acetylcysteine and polyethylene glycol via colonoscopy

J Cyst Fibros. 2023 Nov;22(6):1123-1124. doi: 10.1016/j.jcf.2023.06.014. Epub 2023 Jul 8.

Authors

Ikenna K Emelogu¹, Cynthia N Tran², Wendy R Greene³, Joshua D Novak²

Affiliations

¹ Division of Digestive Diseases, Emory University School of Medicine, Postal address: 615 Michael Street, Ste. 201, Atlanta 30322, Georgia. Electronic address: [email protected].
² Division of Digestive Diseases, Emory University School of Medicine, Postal address: 615 Michael Street, Ste. 201, Atlanta 30322, Georgia.
³ Department of Surgery, Emory University School of Medicine, Atlanta, GA, USA.

PMID: 37429745
DOI: 10.1016/j.jcf.2023.06.014

Abstract

We describe a case of a 46-year-old woman with cystic fibrosis who presented with several days of abdominal pain and distension. She was found to have a small bowel obstruction with inspissated stool in the distal ileum on CT imaging. Despite initial management with conservative measures, her symptoms worsened. She was taken for urgent colonoscopy with administration of 4% N-acetylcysteine (NAC) and polyethylene glycol (PEG) at the distal ileum with resultant dissolution of the fecalith. Over the following days, her symptoms improved, and she was discharged with outpatient follow-up.

Keywords: Colonoscopy; Cystic fibrosis; DIOS; Distal intestinal obstruction syndrome; N-acetylcysteine; Polyethylene glycol.

Publication types

Case Reports

MeSH terms

Acetylcysteine
Colonoscopy
Cystic Fibrosis* / diagnosis
Female
Humans
Intestinal Obstruction* / diagnosis
Intestinal Obstruction* / etiology
Intestinal Obstruction* / therapy
Middle Aged
Polyethylene Glycols

Substances

Polyethylene Glycols
Acetylcysteine