Ileus
Ileus (paralytic ileus, adynamic ileus) is temporary absence of the normal contractile movements of the intestinal wall.
Like an obstruction of the intestines, ileus prevents the passage of intestinal contents. Unlike a mechanical obstruction, though, ileus rarely leads to rupture.
Ileus commonly occurs for 24 to 72 hours after abdominal surgery. It may also be caused by an infection or a blood clot inside the abdomen, atherosclerosis that reduces the blood supply to the intestine, or an injury to an intestinal artery or vein. Disorders outside the intestine may cause ileus, such as kidney failure or abnormal levels of blood electrolytes--low potassium or high calcium levels, for example. Other causes of ileus are use of certain drugs (especially opioid analgesics and anticholinergic drugs (see Section 2, Chapter 14)) and an underactive thyroid gland.
Symptoms and Diagnosis
The symptoms of ileus are abdominal bloating, vomiting, severe constipation, loss of appetite, and cramps.
A doctor hears few bowel sounds or none at all through a stethoscope. An x-ray of the abdomen shows bulging loops of intestine. Occasionally, doctors evaluate the situation using colonoscopy (examination of the large intestine with a flexible viewing tube).
Treatment
The buildup of gas and liquid caused by ileus must be relieved. Sometimes a tube is passed through the anus into the large intestine to relieve the pressure. In addition, a tube is passed through the nose into the stomach or small intestine, and suction is applied to relieve pressure and expansion (distention). The person is not allowed to eat or drink anything until intestinal function normalizes (or returns). Fluids and electrolytes (such as sodium, chloride, and potassium) are given intravenously.
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