Affects small bowel where normal peristalsis temporally stops - paralytic or adynamic ileus
Pseudo-obstruction a functional obstruction of the large bowel. Present with an obstruction but no mechanical cause if found. Less common
Causes/Factors
- Injury to the bowel
- Handling of the bowel during surgery
- Inflammation of infection in or nearby the bowel (Peritonitis, Appendicitis, pancreatitis or pneumonia)
- Electrolyte Imbalance
Usually occurs after surgery and resolves in a few days with supportive care
Signs & Symptoms
- Vomiting (particularly green bilious vomiting)
- Abdominal distention
- Diffuse abdominal pain
- Absolute constipation and lack of flatulence
- Absent bowel sounds (as opposed to the “tinkling” bowel sounds of mechanical obstruction)
Investigations
- Bloods to look for infection source if cause not known
Management
The ileus will usually resolve with treatment of the underlying cause. Management involves supportive care.
Supportive care involves:
- Nil by mouth or limited sips of water
- NG tube if vomiting
- IV fluids to prevent dehydration and correct the electrolyte imbalances
- Mobilisation to helps stimulate peristalsis
- Total parenteral nutrition (TPN) may be required whilst waiting for the bowel to regain function