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Ileus
From Wikipedia, the free encyclopedia

Ileus is a disruption of the normal propulsive ability of the Ileus

gastrointestinal tract.´
Classification and external resources

Ileus is commonly defined simply as bowel obstruction.[1] ICD-10 K31.5 (http://apps.who.int

[2] /classifications/apps/icd/icd10online
However, authoritative sources define it as decreased
motor activity of the GI tract due to non-mechanical /?gk20.htm+k315) , K56.0
causes[3][4]. In such sense, this does not include motility (http://apps.who.int/classifications
disorders that result from structural abnormalities, and, /apps/icd/icd10online
therefore, some mechanical obstructions are misnomers, /?gk55.htm+k560) , K56.3
such as gallstone ileus and meconium ileus, and are not (http://apps.who.int/classifications
true examples of ileus. [5] /apps/icd/icd10online
/?gk55.htm+k563) , K56.7
(http://apps.who.int/classifications
Contents /apps/icd/icd10online
/?gk55.htm+k567) , P75.
1 Types (http://apps.who.int/classifications
1.1 Bowel obstruction /apps/icd/icd10online
1.2 Intestinal atony or paralysis /?gp75.htm+p75) , P76.1
1.2.1 Pathogenesis (http://apps.who.int/classifications
2 Symptoms /apps/icd/icd10online
3 Risk factors /?gp75.htm+p761)
4 Treatment in humans
ICD-9 537.2 (http://www.icd9data.com
5 Complications
6 External links /getICD9Code.ashx?icd9=537.2) ,
7 See also 560.1 (http://www.icd9data.com
8 References /getICD9Code.ashx?icd9=560.1) ,
560.31 (http://www.icd9data.com
/getICD9Code.ashx?icd9=560.31) ,
Types 777.1 (http://www.icd9data.com
/getICD9Code.ashx?icd9=777.1) ,
Decreased propulsive ability may be broadly classified as 777.4 (http://www.icd9data.com
caused either by bowel obstruction or intestinal atony or /getICD9Code.ashx?icd9=777.4)
paralysis. However, there are instances where there
DiseasesDB 6706
symptoms and signs of a bowel obstruction, but with
absence of a mechanical obstruction, mainly in acute (http://www.diseasesdatabase.com
colonic pseudoobstruction, also known as Ogilvie's /ddb6706.htm)
syndrome. MeSH D045823 (http://www.nlm.nih.gov
/cgi/mesh/2010/MB_cgi?field=uid&
Bowel obstruction term=D045823)

Main article: Bowel obstruction

Bowel obstruction is generally a mechanical obstruction of the gastrointestinal tract.

Intestinal atony or paralysis

Paralysis of the intestine is often termed paralytic ileus. To be termed "paralytic ileus," the intestinal

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paralysis need not be complete, but it must be sufficient to prohibit the passage of food through the intestine
and lead to intestinal blockage.

Paralytic ileus is a common side effect of some types of surgery, in case it is commonly called postsurgical
ileus. It can also result from certain drugs and from various injuries and illnesses. Paralytic ileus causes
constipation and bloating. On listening to the abdomen with a stethoscope, no bowel sounds are heard
because the bowel is inactive.

A temporary paralysis of a portion of the intestines occurs typically after an abdominal surgery. Since the
intestinal content of this portion is unable to move forward, food or drink should be avoided until peristaltic
sound is heard from auscultation of the area where this portion lies.

Pathogenesis

Intestinal atony or paralysis may be caused by inhibitory neural reflexes,

inflammation or other implication of neurohumoral peptides.

Symptoms
Symptoms of ileus include, but are not limited to:

moderate, diffuse abdominal discomfort

constipation Gangrenous ileum.
abdominal distension
nausea/vomiting, especially after meals
lack of bowel movement and/or flatulence
excessive belching

Risk factors
gastrointestinal surgery or other GI procedures
electrolyte imbalance
diabetic ketoacidosis (DKA)[6], and other causes of metabolic acidosis
hypothyroidism
medications (e.g. opiates)
severe illness (Inflammation with peritonitis)
spinal cord injury (SCI), those with injury above thoracic vertebrae 5 (T5) will have hypomotility
problems within the bowel

Treatment in humans
Nil per os (NPO or "Nothing by Mouth") is mandatory in all cases. Nasogastric suction and parenteral feeds
may be required until passage is restored.

There are several options in the case of paralytic ileus. Most treatment is supportive. If caused by
medication, the offending agent is discontinued or reduced. Bowel movements may be stimulated by
prescribing lactulose, erythromycin or, in severe cases (Ogilvie's syndrome), neostigmine.

If possible the underlying cause is corrected (e.g. replace electrolytes).

Complications

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Ileus may increase adhesion formation, because intestinal segments have more prolonged contact, allowing
fibrous adhesions to form, and intestinal distention causes serosal injury and ischemia. Intestinal distention
has been shown to cause adhesions in foals [7]. Some respondents also mentioned the importance of walking
horses postoperatively to stimulate motility. Repeat celiotomy to decompress chronically distended small
intestine and remove fibrinous adhesions is also a useful method of treating ileus and reducting adhesions,
and it has been associated with a good outcome [8][9]

External links
Medline Medical Encyclopedia: Intestinal Obstruction (http://www.nlm.nih.gov/medlineplus
/ency/article/000260.htm)

See also
Bowel obstruction

References
1. ^ thefreedictionary.com > Ileus (http://medical-
dictionary.thefreedictionary.com/ileus) Citing:
Dorland's Medical Dictionary for Health
Consumers. 2007
The American Heritage Medical Dictionary
Copyright 2007
Mosby's Medical Dictionary, 8th edition.
2009
Saunders Comprehensive Veterinary
Dictionary, 3 ed. 2007
2. ^ [http://www.merriam-webster.com/medical/ileus
Merriam-Webster's medical dictionary. Retrieved
Nov, 9, 2010
3. ^ Townsend CM, Beauchamp RD, Evers BM,
Mattox KL. Sabiston Textbook of Surgery. The
biological basis of modern surgical practice. 17/e.
Elsevier Saunders, 2004.
4. ^ Livingston EH, Passaro EP. Postoperative ileus.
Retrieved from "http://en.wikipedia.org/wiki/Ileus"
Categories: Digestive system | Diseases of intestines
Dig Dis Sci 1990;35:121.
5. ^ Feldman M, Friedman LS, Brandt LJ, Sleisenger
MH. Sleisenger & Fordtran's Gastrointestinal and
Liver Disease. Intestinal Obstruction and Ileus.
8/e. Elsevier Saunders, 2006.
6. ^ Kitabchi, AE, Umpierrez, GE, Murphy, MB, et
al. Management of hyperglycemic crises in patients
with diabetes mellitus (technical review). Diabetes
Care 2001; 24:131.
7. ^ Lundin C, Sullins KE, White NA and al.
Induction of peritoneal adhesions with small
intestinal ischaemia and distention in the foal.
Equine Vet J 21: 451, 1989
8. ^ Vachon AM, Fisher AT. Small intestinal
herniation through the epiploic foramen: 53 cases
(1987-1993). Equine Vet J 27: 373, 1995
9. ^ Southwood LL, Baxter GM. Current concepts in
management of abdominal adhesions. Vet Clin
North Am Eq Prac 13:2 415 1997

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