Ileus

Question 1

what is the difference between small bowel obstruction and Ileus

Answer 1

small bowel obstruction is impaired motility of the GI tract due to mechanical obstruction however, Ileus is impaired motility NOT due to obstruction

Question 2

what is Ileus

Answer 2

Ileus is a slowing of gastrointestinal motility accompanied by distention, in the absence of a mechanical intestinal obstruction. It is a diagnosis of exclusion after bowel obstruction has been ruled out.

Question 3

what causes Ileus

Answer 3

physiological stress can be a causative factor, surgery can cause physiological stress,

sepsis, metabolic derangements, GI diseases

Question 4

presenting signs and symptoms of Ileus

Answer 4

abdominal distension, colicky abdominal pain, vomiting, constipation,

NO SIGNS OF MECHANICAL OBSTRUCTION

Question 5

what patients will Ileus be quite common in

Answer 5

those that are hospitalised post-gastro surgery

Question 6

what investigations will be done for someone with Ileus

Answer 6

FBC, serum electrolytes, LFTs

CT and AXR

Question 7

management of Ileus in POSTOPERATIVE patients

Answer 7

nil by mouth and give IV fluids and replace electrolytes,

REDUCE opioid analgesia,

NG tube if necessary

Question 8

management of Ileus in patients where surgery isn’t the cause

Answer 8

nil by mouth, IV fluids, IV electrolyte replacement,

treat the underlying cause

NG tube

Question 9

what does the NG tube help with

Answer 9

allows decompression, reducing the risk of aspiration

Question 10

prognosis of Ileus

Answer 10

post operative Ileus usually resolves in 3-4 days with management