Ileus

Question 1

ESSENCE

Answer 1

Slowing of GI motility accompanied by distention, in the absence of mechanical intestinal obstruction

Diagnosis of exclusion after bowel obstruction ruled out

Question 2

CLINICAL FEATURES

Presentation

Answer 2

• Most commonly following surgery
• Nausea and vomiting
• Abdominal distention
• No features of mechanical obstruction or peritoneal inflammation)

Question 3

AETIOLOGY

Risk factors

Answer 3

• Abdominal surgery
• Acute/systemic illness (eg MI, pneumonia, acute cholecystitis, pancreaitits, sepsis)
• Electrolyte imbalance
• Opoid analgesia

Question 4

INVESTIGATIONS

First choice

Answer 4

• X-rau
• Full blood work

Question 5

MANAGEMENT

General principles

Answer 5

• In postoperative cause nothing by mouth, IV hydration and reduction in opiod analgesia or change to non-opiod
• If non-surgical cause nothing by mouth and IV hydration with management of underlying conditions