Exxcellence pearls: postoperative ileus

Question 0

How is ileus generally managed?

Answer 0

NPO status, IV fluids, expectant management. NG tube if necessary. Avoid avoid narcotics as possible.

Question 1

How long does postoperative ileus of the small bowel take to resolve?

Ileus of the colon?

Answer 1

24 hours

3-4 days

Question 3

What should be considered if ileus does not resolve within 4 days? What should be ordered?

Answer 3

Must consider obstruction or abscess. Abdominal CT with contrast should be ordered.

Question 4

What effect does oral contrast have on ileus?

Answer 4

Water-soluble contrast such as Gastrografin has been shown to help in the resolution of ileus.