Paralytic Ileus Flashcards
1
Q
What is paralytic ileus?
A
Also known as functional obstruction, it is the cessation of normal gut peristalsis. Defined as persisting for more than 3 days
2
Q
What are the main causes of paralytic ileus?
A
- Generalised peritonitis
- Drugs
- Electrolyte imbalance
- Post operative state (bowel is paralysed after any manual handling of the bowels during surgery and remains paralysed for 2 days. This usually resolves spontaneously so is not terms paralytic ileus)
3
Q
What is the pathophysiology of paralytic ileus?
A
Similar to those of mechanical obstruction
- Dilation of the bowel due to pressure causes abdominal distension
- As the abdomen distends, blood supply is compromised
- Results in ischaemia which is not reversed may go onto infarction and perforation
4
Q
What are the clinical features of paralytic ileus?
A
- Vomiting
- Constipation
- Abdominal distension
=> But not colicky pain
5
Q
What is Ogilvie syndrome?
A
- Particular form of paralytic ileus which affects the large bowel
- Occurs as a result of interference with the autonomic nerve supply to the gut
6
Q
What are the risk factors of Ogilvie syndrome?
A
- Severe blunt trauma
- Othopaedic trauma
- Joint replacement procedures
7
Q
What is gallstone ileus?
A
A rare form of small bowel obstruction in which a gallstone enters the bowel and causes a mechanical obstruction. Gallstone ‘ileus’ is a misnomer
