Female patient diagnosed with cystic fibrosis at birth and submitted to sequential bilateral lung transplantation at age 13.
In October 2008, the patient consulted for 4 days of abdominal pain in both hypochondria with absence of bowel movements and gases per year.
On physical examination at admission only a distended abdomen without peritoneal signs stood out.
Laboratory tests showed mild anemia (32.7%), hemoglobin (11 g/dl) and slightly elevated CRP (1 mg/Lt).
A simple abdominal X-ray was requested, which showed hydroaerial dilation of the loops of the proximal small intestine and the rest of the intestinal loops with abundant fecal content.
In this scenario, it was decided to administer prophylaxis (ceftriaxone/metronidazole) and to start PEG 3,350 oral route associated with rectal bleeding in the right abdominal area (1,000 cecum of distilled water + 15 g of
A computed tomography of the abdomen and pelvis was requested, which showed the presence of estercoraceous content from 40 to 50 cm from the distal ileum to the cecum and proximal transverse colon confirming the diagnosis of SOID.
Due to the low tolerance and poor response to the use of PEG via obscure and suclysis, contrast media was administered via nasogastric tube (Gastrografin® 100 ml diluted in 400 mi of saline solution).
A plain control abdominal X-ray showed disappearance of small intestine loops in the upper abdomen.
She was discharged on the fourth day with pancreatic enzymes.
Despite this treatment, the patient developed a new SOID 8 months after discharge.
This new episode was treated with Gastrografin® from the beginning, with a very good response.
Currently, 10 months after the first episode, she has not presented new episodes of SOID, neither abdominal pain nor constipation.
