Ileus overview: Difference between revisions

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==Causes==
==Causes==
Ileus can be caused by both mechanical obstructions and non-mechanical obstructions.


==Differentiating {{PAGENAME}} from Other Diseases==
==Differentiating {{PAGENAME}} from Other Diseases==

Revision as of 02:11, 4 February 2018

Ileus Microchapters

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Ileus is a disruption of the normal propulsive gastrointestinal motor activity from non-mechanical mechanisms.[1][2] Motility disorders that result from structural abnormalities are termed mechanical bowel obstruction. Some mechanical obstructions are misnomers, such as gallstone ileus and meconium ileus, and are not true examples of ileus by the classic definition. [3]

Historical Perspective

The word ileus has been derived from the Greek word "είλειν" which means to twist. In 1958, Robertson, Eddy, and Vosseler were the first to describe a case of adynamic ileus associated with cecal perforation.

Classification

There is no specific system for classification of postoperative ileus. However, based on etiology, postoperative ileus may be classified into drug induced ileus, metabolic and electrolyte abnormalities induced ileum, and systemic disorder induced ileus.

Pathophysiology

Causes

Ileus can be caused by both mechanical obstructions and non-mechanical obstructions.

Differentiating Ileus overview from Other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications, and Prognosis

Natural History

Complications

Prognosis

Diagnosis

Diagnostic Criteria

History and Symptoms

Physical Examination

Laboratory Findings

Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

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. There are several options in the case of paralytic ileus. Most treatment is supportive. 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. If possible the underlying cause is corrected (e.g. replace electrolytes).

Surgery

Surgery may be needed to relieve the obstruction if the tube does not relieve the symptoms, or if there are signs of tissue death.

Prevention

Prevention depends on the cause. Treating conditions, such as tumors and hernias, that can lead to obstruction may reduce your risk of getting an obstruction. Some causes of obstruction cannot be prevented.

References

  1. Townsend CM, Beauchamp RD, Evers BM, Mattox KL. Sabiston Textbook of Surgery. The biological basis of modern surgical practice. 17/e. Elsevier Saunders, 2004.
  2. Livingston EH, Passaro EP. Postoperative ileus. Dig Dis Sci 1990;35:121.
  3. Feldman M, Friedman LS, Brandt LJ, Sleisenger MH. Sleisenger & Fordtran's Gastrointestinal and Liver Disease. Intestinal Obstruction and Ileus. 8/e. Elsevier Saunders, 2006.