Ileus

Definition

Ileus is a temporary and partial or complete obstruction of the normal propulsive ability of the intestines, resulting in the failure of intestinal contents to progress through the digestive tract. It is a common complication that can occur after abdominal surgery or in various medical conditions affecting the gastrointestinal system.

5 Must Know Facts For Your Next Test

1. Ileus can lead to the accumulation of gas, fluids, and waste products within the intestines, causing abdominal distension, nausea, vomiting, and constipation.
2. Risk factors for developing ileus include abdominal surgery, trauma, certain medications (e.g., opioids), electrolyte imbalances, and underlying medical conditions affecting the gastrointestinal system.
3. Physical examination findings in ileus may include a distended abdomen, decreased or absent bowel sounds, and tenderness upon palpation.
4. Diagnostic tests used to evaluate ileus may include abdominal X-rays, CT scans, or other imaging studies to assess the extent and location of the obstruction.
5. Management of ileus typically involves supportive care, such as nasogastric decompression, fluid and electrolyte replacement, and the avoidance of medications that can further impair intestinal motility.

Review Questions

• Explain the pathophysiology of ileus and how it can develop as a complication after abdominal surgery.
  • Ileus is a disruption in the normal propulsive ability of the intestines, leading to the failure of intestinal contents to progress through the digestive tract. After abdominal surgery, the manipulation and trauma to the intestines can cause a temporary paralysis or decreased motility of the intestinal muscles, known as paralytic ileus. This leads to the accumulation of gas, fluids, and waste products within the intestines, causing abdominal distension, nausea, vomiting, and constipation. The development of ileus in the postoperative setting is a common complication that can significantly impact a patient's recovery and delay the return of normal gastrointestinal function.
• Describe the key physical examination findings and diagnostic tests used to evaluate a patient with suspected ileus.
  • The physical examination of a patient with suspected ileus may reveal a distended abdomen, decreased or absent bowel sounds, and tenderness upon palpation. Diagnostic tests used to evaluate ileus include abdominal X-rays, which can show dilated intestinal loops and air-fluid levels, and CT scans, which can provide more detailed information about the location and extent of the obstruction. These imaging studies are crucial in differentiating ileus from other potential causes of intestinal obstruction, such as mechanical bowel obstructions. The combination of clinical findings and diagnostic test results helps healthcare providers confirm the diagnosis of ileus and guide appropriate management.
• Analyze the role of supportive care and medication management in the treatment of ileus, and explain how these interventions can help resolve the condition.
  • The primary management of ileus involves supportive care measures to address the underlying cause and allow the intestines to regain normal motility. This typically includes nasogastric decompression to relieve abdominal distension and prevent further vomiting, as well as fluid and electrolyte replacement to maintain hydration and correct any imbalances. Medications that can further impair intestinal motility, such as opioids, are often avoided or minimized during this time. Additionally, healthcare providers may prescribe prokinetic agents or other medications that can help stimulate intestinal contractions and facilitate the passage of intestinal contents. By addressing the underlying factors contributing to ileus and supporting the body's natural recovery processes, these interventions can help resolve the condition and restore normal gastrointestinal function.

Related terms

Bowel Obstruction: A partial or complete blockage of the intestines that prevents the normal movement of intestinal contents.

Paralytic Ileus: A type of ileus caused by the temporary paralysis of the intestinal muscles, often due to factors such as surgery, medications, or electrolyte imbalances.

Adynamic Ileus: A type of ileus characterized by the absence of normal intestinal motility, typically seen in conditions like peritonitis, pancreatitis, or after abdominal surgery.