ILEUS

'Ileus', formerly called 'iliac passion', refers to limited or absent intestinal passage.

Contents

Types

Mechanical ileus

Paralytic ileus

Symptoms

Risk Factors

Diagnosis

Treatment

External links

See also

Types

Mechanical ileus

Main articles: Bowel obstruction

Mechanical ileus refers to a lack of passage due to an obstruction, which can be located anywhere in the bowel. The cause can be volvulus or a malignancy inside and outside the abdomen. Therapy consists of surgery.
Meconium ileus is a particular type of mechanical ileus only seen in newborn babies.
Gallstone ileus, associated with a cholecystenteric fistula.

Paralytic ileus

Paralytic ileus refers to a lack of passage due to paralysis of the bowel, i.e. Ogilvie syndrome. This can be caused by intra-abdominal surgery, medication (morphinomimetica), injury or infection.

Symptoms

Symptoms of ileus include, but are not limited to:

★ moderate, diffuse abdominal discomfort

★ constipation

★ abdominal distension

★ nausea/vomiting, especially after meals

★ lack of bowel movement and/or flatulence

Risk Factors

★ gastrointestinal surgery or other GI procedures

★ electrolyte imbalance

★ hypothyroidism

★ medications (e.g. opiates)

★ severe illness

Diagnosis

An X-Ray of the abdomen or a CT can be done, though paralytic ileus may not be diagnosed by the radiological investigations.

Treatment

Nil per os (NPO or "Nothing by Mouth") is mandatory in all cases. Nasogastric suction and parenteral feeds may be required until passage is restored.
Most cases of mechanical ileus require surgery, while there are several options in the case of paralytic ileus. If caused by medication, the offending agent is discontinued or reduced. Bowel movements may be stimulated by prescribing lactulose, erythromycin or in severe cases, (Ogilvie's syndrome) neostigmine.
Otherwise correct the underlying cause (e.g. replace electrolytes).

External links

★ Information from the Merck Manual

See also

★ Bowel obstruction