Ileus

(Paralytic ileus, adynamic ileus; palsy)

Under a ileus refers to temporary arrest of intestinal peristalsis. It usually occurs after abdominal operations, v. a. if it has been tampered with the intestine. Symptoms include nausea, vomiting, and vague discomfort in the abdomen. Diagnosis is based on radiological findings and clinical assessment. Treatment is supportive with nasogastric tube and i.v. Fluid administration.

Under a ileus refers to temporary arrest of intestinal peristalsis. It usually occurs after abdominal operations, v. a. if it has been tampered with the intestine. Symptoms include nausea, vomiting, and vague discomfort in the abdomen. Diagnosis is based on radiological findings and clinical assessment. Treatment is supportive with nasogastric tube and i.v. Fluid administration. Etiology The most common cause is abdominal surgery Other causes include intraperitoneal or retroperitoneal inflammation (eg. As appendicitis [Appendicitis] diverticulitis [diverticulitis], perforated duodenal ulcer [Peptic ulcer disease]) retroperitoneal or intra-abdominal hematoma (eg., From a ruptured abdominal aortic aneurysm [Abdominal aortic aneurysms (AAA)], lumbar compression fracture) metabolic disorders (eg. as hypokalemia [hypokalemia]) drugs (eg. as opioids, anticholinergics, occasionally calcium channel blockers) Sometimes kidney or thoracic diseases (eg. as lower rib fractures, lower lobe pneumonia, myocardial infarction) disorders of the stomach and colonic motility are common after abdominal surgery. The small intestine is typically the least affected, its motility and absorption are back to normal within a few hours after surgery. Gastric emptying is h or generally for about 24 more impaired. The intestine is often the most affected and can h for another 48 to 72 or longer stay inactive. Symptoms and signs The symptoms consist of abdominal distension, nausea, vomiting, and vague discomfort. The pain rarely has the classic colicky pattern as in mechanical ileus. There may be constipation or disposal of small quantities of aqueous chair. Auscultation results in a “silent” abdomen or minimal peristalsis. If the underlying cause is not inflammatory origin, the abdomen is not sensitive. Diagnosis Clinical Evaluation Partial radiographs Most important is the distinction of paralytic ileus by a bowel obstruction. In both forms, the X-rays show air-filled swellings isolated intestinal segments. However, during postoperative ileus, the accumulation of air is more in the colon than in the small intestine. Postoperative accumulation of air in the small intestine is often indicated on the existence of a complication out (for example, closure, peritonitis. [Acute abdominal pain: peritonitis]). In other forms of ileus, the X-rays look similar to the closure. The distinction can be difficult if there is no clear clinical evidence for one or the other ileus. A contrast-enhanced CT may be useful in distinguishing between the two, and point to an underlying cause of intestinal obstruction. Therapy NGS infusions The treatment consists in a continuous suction on the stomach probe, fasting, i.v. Fluid and electrolyte replacement, the lowest possible doses of sedatives and avoiding opiates and anti-cholinergic drugs. Particularly important is the maintenance of adequate serum potassium (> 4 mEq / l [> 4 mmol / l]). Ileus, which is more than a week has probably a mechanical cause and a laparotomy should be considered. Sometimes a Dickdarmileus can be reduced by a colonoscopic pressure relief, rarely a Zäkostomie is required. A colonoscopic relief in the treatment of so-called. Pseudo-obstruction (Ogilvie’s syndrome) helpful, it consists in an apparent lock on the splenic flexure, although neither found by contrast enema or by colonoscopy a cause for the stoppage of air and chair transport at this point can be. Some clinicians use i.v. Neostigmine (which is a cardiac monitoring required makes) to treat the Ogilvie syndrome.

Health Life Media Team

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