Post-operative Ileus

Pseudo-obstruction
Paralytic ileus
Limited to the colon
Involves both small bowel and colon
Occurs in elderly bedridden patients
Any age group particularly in post-operative patients
There will be abdominal distension without pain and tenderness
Abdominal distension associated with pain and tenderness
Increased risk of perforation if caecum is >12 cm in diameter
No such risks
Mechanical Obstruction
Caused by adhesions, volvulus, hernias, intussusception, foreign bodies or neoplasms

Characteristics of Ileus,Pseudo-obstructionand Mechanical Obstruction

 
Ileus
Pseudo-obstruction
Mechanical obstruction
Symptoms
Nausea, vomiting, mild abdominal pain, bloating, obstipation and constipation
Nausea, vomiting, anorexia, crampy abdominal pain, obstipation and constipation
Nausea, vomiting, anorexia, crampy abdominal pain, obstipation and constipation
Physical examination
Distension (+), tympanic on percussion, silent abdomen with absent bowel sounds
Distension (+), localised tenderness (+), borborygmi sounds heard. Hypo- or hyperactive bowel sounds heard
Distension (+), localised tenderness (+), borborygmi sounds heard. High-pitched bowel sounds heard
Plain radiograph features
Diaphragm elevated, small and large bowel dilatation seen

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Sep 23, 2016 | Posted by in OBSTETRICS | Comments Off on Post-operative Ileus

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