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Ileus, formerly called iliac passion, refers to limited or absent intestinal passage.
Types
Mechanical ileus
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.
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 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
See also
"Ileus"