Ileus Flashcards
What is a bowel obstruction?
Functional obstruction of intestines with reduced or absent peristalsis without evidence of mechanical blockage
Bowel obstruction can lead to significant complications if not properly managed.
What are the types of functional bowel obstruction?
- Postoperative Ileus
- Infection or Inflammation
- Hypothyroidism
- Electrolyte Abnormality
Each type has different underlying causes and management strategies.
What is postoperative ileus?
Transient paralysis of smooth muscle caused by trauma during surgery - **Pseudobstruction **
Most common cause of functional bowel obstruction.
What infections can cause functional bowel obstruction?
Appendicitis and peritonitis
These infections can lead to inflammation and subsequent bowel dysfunction.
List some causes of functional bowel obstruction.
- Post-operative Ileus
- Heart failure
- Opioid medication
- Systemic infection
Identifying the cause is crucial for effective treatment.
What are the risks for developing bowel obstruction?
• Prior abdominal operation
• Opioid use
These factors can significantly increase the likelihood of developing ileus.
What are common symptoms of bowel obstruction?
- abdominal distention/bloating
- abdominal pain
- nausea/vomiting
- inability to pass flatus
- inability to tolerate an oral diet
These symptoms can vary in severity based on the underlying cause.
What are the signs of bowel obstruction?
• Abdominal distention and tenderness on palpation
• Reduced or absent bowel sounds on auscultation
• Electrolyte abnormalities: LOW K+, Na+
Physical examination can reveal critical signs for diagnosis.
What is the management for unstable bowel obstruction?
ABCDE approach
This is a critical care approach focusing on airway, breathing, circulation, disability, and exposure.
What steps are involved in the management of stable bowel obstruction?
- Bloods: U&Es derranged
- Imaging: AXR, CT, US
These steps help in confirming diagnosis and ruling out other conditions.
What supportive care is recommended for bowel obstruction?
1) **Nil by mouth **
2) Drip and Suck: NGT tube placement for N/V and IV fluids
3) Analgesia
4) Electrolyte repletion
+ get patient up and walking
Supportive care is essential for recovery and prevention of complications.
What indicates a positive response in bowel obstruction management?
Trial of oral enteral nutrition
A positive response suggests improvement in bowel function.
What indicates a worsening response in bowel obstruction management?
CT with contrast to look for complications
This may include sepsis, new obstructions, anastomotic leak, abscess, or hepatoma.
What is important to avoid in post-operative ileus?
Opioids
Opioids can exacerbate ileus by reducing bowel motility.
What should be investigated in non-postoperative ileus?
• Heart failure
• Systemic infection (UTI)
• Metabolic abnormalities
• Medication (opioids)
• Recent chemo/radiation
Identifying these causes is vital for appropriate management.
How is ileus diagnosed?
Ileus is a diagnosis by exclusion, ruling out all other causes before diagnosing
Mechanical obstruction must be ruled out to confirm ileus.
