Ileus

Question 1

What is ileus? How is it different to pseudo-obstruction?

Answer 1

Ileus
-normal peristalsis in the SMALL bowel stops

Pseudo-obstruction
-functional obstruction in LARGE bowel where symptoms of bowel obstruction but without mechanical obstruction present

Question 2

What are the causes of ileus?

Answer 2

Bowel injury
Handling of bowel during surgery
Inflammation or infection of abdomen
Hypokalaemia or hyponatraemia

Question 3

How does someone with ileus present? How can you distinguish between ileus and obstructed bowel on examination?

Answer 3

Vomiting- green bilious vomit
Abdominal distention
Diffuse abdo pain
Absolute constipation + lack of flatulence
ABSENT bowel sounds (tinkling heard in mechanical bowel obstruction)

Question 4

What is involved in the supportive care of ileus?

Answer 4

NBM
NG tube
IV fluids- prevent dehydration + correct electrolyte balance
Mobilisation can help to stimulate peristalsis
Total parenteral nutrition whilst bowel regaining function (nutrition via IV)