ileus
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Introduction
Etiology
Pathology
- lack of intestinal peristalsis
Clinical manifestations
- pain is generally constant & mild
- abdominal distension
Laboratory
- blood work generally of no value
- plain abdominal radiograph (KUB) supine & upright
- gas in both small & large bowel.
Differential diagnosis
Management
- postoperative ileus
- minimization of opioid use*[2]
- adequate hydration
- bowel rest
- electrolyte repletion
- ambulation[2]
- alvimopan may be useful[4]
- chewing gum may be useful[2][3]
* opioids unlikely to be only cause of ileus, thus methylnaltrexone not indicated[5]
More general terms
More specific terms
Additional terms
References
- ↑ Harrison's Principles of Internal Medicine, 13th ed. Companion Handbook, Isselbacher et al (eds), McGraw-Hill Inc. NY, 1995, pg 829-39.
- ↑ 2.0 2.1 2.2 2.3 Medical Knowledge Self Assessment Program (MKSAP) 18, American College of Physicians, Philadelphia 2018
- ↑ 3.0 3.1 The NNT: Chewing Gum for Reducing Post-Caesarian Section Ileus. http://www.thennt.com/nnt/chewing-gum-for-reducing-post-caesarian-section-ileus/
Craciunas L, Sajid MS, Ahmed AS. Chewing gum in preventing postoperative ileus in women undergoing caesarean section: a systematic review and meta- analysis of randomised controlled trials. BJOG. 2014 Jun;121(7):793-9; discussion 799 PMID: https://www.ncbi.nlm.nih.gov/pubmed/24628729 - ↑ 4.0 4.1 Taguchi A, Sharma N, Saleem RM, Sessler DI, Carpenter RL, Seyedsadr M, Kurz A. Selective postoperative inhibition of gastrointestinal opioid receptors. N Engl J Med. 2001 Sep 27;345(13):935-40. PMID: https://www.ncbi.nlm.nih.gov/pubmed/11575284 Free Article
- ↑ 5.0 5.1 Vilz TO, Stoffels B, Strassburg C, et al. Ileus in adults. Dtsch Arztebl Int. 2017;114:508-18. PMID: https://www.ncbi.nlm.nih.gov/pubmed/28818187