Ileus causes

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Akshun Kalia M.B.B.S.[2]

Overview

Common causes of ileus include surgery (major abdominal & non-abdominal surgeries), metabolic and electrolyte disturbances (such as hyponatremia, hypokalemia, hypocalcemia and hypomagnesemia), endocrinological disorders (such as diabetes, hypoparathyroidism, hypothyroidism, and adrenal insufficiency), systemic disorders (such as myocardial infarction, pneumonia, renal failure), trauma, sepsis, and drugs (such as opiates, anticholinergic agents, autonomic blockers, tricyclic antidepressants and general anesthesia).

Causes

Common Causes

The common causes of ileus include:

• Any abdominal surgery
• Acute pancreatitis
• Hypokalemia
• Mechanical ventilation
• Morphine
• Pancreatitis
• Peritonitis
• Retroperitoneal hematoma
• Mesenteric infarction
• Uremia
• Urosepsis
• Trauma

Causes by Organ System

Cardiovascular	Heart Attack
Chemical/Poisoning	Lead poisoning, Thallium
Dental	No underlying causes
Dermatologic	No underlying causes
Drug Side Effect	Anticholinergic drugs, Acetaminophen and Oxycodone, Antihistamines, Benzatropine, Ixabepilone, Ioxilan,Lanthanum carbonate, Loperamide, meclofenamate,Meropenem, Morphine, Olanzapine, Opiates, Pramipexole, Vinblastine
Ear Nose Throat	No underlying causes
Endocrine	Diabetic coma, Diabetic ketoacidosis, Hyperparathyroidism
Environmental	No underlying causes
Gastroenterologic	Adenomatous polyps, Annular pancreas, Appendicitis, Atresia, Biliary calculus, Cholecystitis, Cholecystolithiasis, Colon Cancer, Complications of intra-abdominal surgery, Congenital megacolon, Crohn's Disease, Diverticular stricture, Diverticulitis, Gallstone ileus, Gastrointestinal bleeding, Hematoma of the bowel wall, Hemoperitoneum, Hernia, Incarcerated hernia, Intestinal ischaemia, Intrabdominal hematoma, intussusception , Megacolon, Mesenteric infarction, Mesenteric ischemia, Multiple polyposis syndromes, Superior mesenteric artery occlusion, Ulcer perforation, Ulcerative colitis, Volvulus
Genetic	Hirschprung's disease, Imperforate anus, Malrotation, Meckel's Diverticulum
Hematologic	Lymphoma, Retroperitoneal hematoma
Iatrogenic	Abdominal surgery, adhesions, Anastomotic leaks, Joint or spine surgery, Laparotomy, Postoperative, Surgery complication, Surgical anastomosis
Infectious Disease	Peritonitis , Abdominal infections, Abdominopelvic abscess, Ascariades, Botulism, Infections, Intrabdominal abscess, intraperitoneal infection, Osteomyelitis of the spine, Pancreatitis, Perinephric abscess, Peritonitis, Pneumatosis intestinalis, Pneumonia, Psoas abscess, Sepsis, Severe generalized infections , Tuberculosis, Urosepsis
Musculoskeletal/Orthopedic	No underlying causes
Neurologic	Spinal cord inflammation, Spinal cord injury
Nutritional/Metabolic	Acute intermittent porphyria
Obstetric/Gynecologic	Endometriosis, Neonatal necrotizing enterocolitis, Pregnancy
Oncologic	Cancer, Peritoneal carcinomatosis, Sarcoma, lymphoma
Ophthalmologic	No underlying causes
Overdose/Toxicity	No underlying causes
Psychiatric	No underlying causes
Pulmonary	Mechanical ventilation
Renal/Electrolyte	Acid-base imbalance disturbance, Hypokalaemia, Hypomagnesemia, Kidney diseases, Pyelonephritis, Renal colic, Uremia
Rheumatology/Immunology/Allergy	Connective tissue disease, Henoch-Schönlein purpura, Scleroderma
Sexual	No underlying causes
Trauma	Injury or trauma to abdomen , Injury to the abdominal blood supply , Penetrating wounds
Urologic	No underlying causes
Miscellaneous	Apoplexy, Burns, Cysts, Disorders that affect muscle function, foreign bodies , Radiation induced stenosis

Causes in Alphabetical Order

Abdominal infections Abdominal surgery Abdominopelvic abscess Acid-base imbalance Acute pancreatitis Acute intermittent porphyria Adenomatous polyps adhesions Anastomotic leaks Annular pancreas Anticholinergic drugs Antihistamines Apoplexy Appendicitis Ascariades Atresia Biliary calculus Botulism Burns Cancer Carcinomatosis Cholecystitis Cholecystolithiasis Colon Cancer Complications of intra-abdominal surgery Congenital megacolon Connective tissue disease Crohn's Disease Cysts Diabetic coma Diabetic ketoacidosis Disorders that affect muscle function Diverticular stricture Diverticulitis Endometriosis foreign bodies

Gallstone ileus Gastrointestinal bleeding Heart Attack Hematoma of the bowel wall Hemoperitoneum Henoch-Schönlein purpura Hernia Hirschprung's disease Hyperparathyroidism Hypokalaemia Hypomagnesemia Imbalance of electrolytes Imperforate anus Incarcerated hernia Infections Injury or trauma to abdomin Injury to the abdominal blood supply Intestinal ischaemia Intrabdominal abscess Intrabdominal hematoma intraperitoneal infection intussusception Ixabepilone Joint or spine surgery Kidney diseases Laparotomy Lead poisoning Lymphoma Malrotation Mechanical ventilation Meckel's Diverticulum Megacolon Mesenteric infarction Mesenteric ischemia Metabolic disturbances Morphine Multiple polyposis syndromes

Narcotic Neonatal necrotizing enterocolitis neoplasms Opiates Osteomyelitis of the spine Pancreatitis Penetrating wounds Perinephric abscess Peritoneal carcinomatosis Peritonitis Pneumatosis intestinalis Pneumonia Porphyria Postoperative Pregnancy Psoas abscess Pyelonephritis Radiation induced stenosis Renal colic Retroperitoneal hematoma Sarcoma Scleroderma Sepsis Severe generalized infections Spinal cord inflammation Spinal cord injury Superior mesenteric artery occlusion Surgery complication Surgical anastomosis Thallium Tuberculosis Ulcer perforation Ulcerative colitis Uremia Urosepsis Volvulus

Causes based on type of obstruction

Earlier, the term ileus was used to describe temporary cessation of intestinal peristalsis. In the recent times, the term "ileus" has been modified to include temporary cessation of intestinal peristalsis in the absence of mechanical obstruction. However, in order to include all the causes, we are hereby including all the causes which may lead to cessation of intestinal peristalsis. The list as below:

Mechanical Obstruction

• Adenomatous polyps
• Adhesions
• Adhesive bands
• Annular pancreas
• Ascariades
• Atresia
• Biliary calculus
• Bowel duplication
• Carcinomatosis
• Colon Cancer
• Congenital megacolon
• Crohn's Disease
• Cysts
• Diverticular stricture
• Diverticulitis
• Endometriosis
• Foreign body
• Gallstone ileus
• Hematoma of the bowel wall
• Hernia
• Hirschprung's disease
• Iatrogenic
• Imperforate anus
• Incarcerated hernia
• Inflammatory
• Intrabdominal abscess
• Intrabdominal hematoma
• Invagination, intussisception
• Ischemia
• Malrotation
• Meckel's Diverticulum
• Megacolon
• Multiple polyposis syndromes
• Neoplasm
• Ovarian Cancer
• Pneumatosis intestinalis
• Postoperative
• Pregnancy
• Radiation induced stenosis
• Sarcoma
• Scleroderma
• Surgical anastomosis
• Therapy with dietary fiber
• Trauma
• Tuberculosis
• Ulcerative colitis
• Volvulus

Non-Mechanical Obstruction

• Acid-base imbalance
• Acute pancreatitis
• Anticholinergics
• Antihistamines
• Apoplexy
• Brain tumor
• Cancer
• Catecholamines
• Cholecystolithiasis
• Connective tissue disease
• Diabetic coma
• Empyema
• Hyperparathyroidism
• Hypokalemia
• Lead poisoning
• Lymphoma
• Mechanical ventilation
• Mesenteric infarction
• Morphine
• Narcotics
• Osteomyelitis of the spine
• Ovarian torsion
• Pancreatitis
• Penetrating wounds
• Perinephric abscess
• Peritoneal carcinomatosis
• Peritonitis
• Pneumonia
• Porphyria
• Postoperative
• Psoas abscess
• Pyelonephritis
• Renal colic
• Retroperitoneal hematoma
• Spinal cord inflammation
• Spinal cord injury
• Spinal cord trauma
• Systemic infection
• Testicular torsion
• Ulcer perforation
• Uremia
• Urosepsis
• Vitamin deficiency

Pseudo-Obstruction

• Aerophagia
• Functional bowel disease

References

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