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
![]() Stay updated, free articles. Join our Telegram channel![]() Full access? Get Clinical Tree![]() ![]() ![]() |