paralytic ileus


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ileus

 [il´e-us]
failure of appropriate forward movement of bowel contents. It may be secondary to either mechanical obstruction of the bowel (mechanical ileus) or a disturbance in neural stimulation (adynamic ileus). Ileus is a surgical emergency that may or may not require surgical intervention; the cause needs to be established promptly.

Adynamic (or paralytic) ileus often accompanies peritonitis and is also found accompanying the colicky pains of gallstones or kidney stones; following spinal cord injury, pneumonia, or other generalized conditions; or being caused by peritoneal contamination by pus (from a perforated appendix) or acid (from a perforated ulcer). Mechanical ileus is that due to adhesions, ischemia, tumor, or stone and requires prompt decompression of the bowel to prevent perforation.
Symptoms. The principal symptoms of ileus are abdominal pain and distention, constipation, and vomiting in which the vomitus may contain fecal material. If the intestinal obstruction is not relieved, the circulation in the wall of the intestine is impaired and the patient appears extremely ill with symptoms of shock and dehydration.
Treatment. Distention of the abdomen is relieved by decompression, which involves intubation with a long, balloon-tipped tube (e.g., miller-abbott tube) that extends to the site of the obstruction, and use of constant suction. Because of the disruption in absorption of fluids and nutrients from the intestinal tract, fluids, electrolytes, and glucose are given intravenously. Surgical intervention to remove the cause of ileus is usually necessary when the obstruction is complete or the bowel is likely to become gangrenous. The type of surgical procedure will depend on the condition of the bowel and the cause of the obstruction. In some cases ileostomy or colostomy, either temporary or permanent, may be necessary. In cases of paralytic ileus due to causes other than contamination by pus or acid, tube decompression may be sufficient, but even in these patients, surgery may be needed to protect the bowel from overdistention and perforation. See also intestinal obstruction for patient care.
adynamic ileus that caused by inhibition of bowel motility; see ileus.
dynamic ileus (hyperdynamic ileus) spastic ileus.
mechanical ileus that caused by a mechanical cause, such as hernia, adhesions, or volvulus; see ileus.
meconium ileus ileus in the newborn due to intestinal obstruction by thick meconium.
paralytic ileus adynamic ileus.
spastic ileus that due to persistent contracture of a bowel segment.
ileus subpar´ta ileus due to pressure of the gravid uterus on the pelvic colon.

a·dy·nam·ic il·e·us

obstruction of the bowel due to paralysis of the bowel wall, usually as a result of localized or generalized peritonitis or shock.
Synonym(s): paralytic ileus

paralytic ileus

GI disease Functional 'obstruction' of intestinal flow, often following abdominal surgery, as well as electrolyte defects–eg, hypokalemia, drugs–eg, phenothiazine, narcotics, gram-negative sepsis, catecholamines, diabetic ketoacidosis, mesenteric vascular disease, porphyria, retroperitoneal hemorrhage, spinal and pelvic fractures. See Gastroparesis, Intestinal obstruction, Volvulus.

a·dy·nam·ic il·e·us

(ā'dī-nam'ik il'ē-ŭs)
Obstruction of the bowel due to paralysis of the bowel wall, usually as a result of localized or generalized peritonitis or shock.
Synonym(s): paralytic ileus.
References in periodicals archive ?
There were 4 cases of paralytic ileus in this study, 3 of which treated conservatively and in one case laprotmy with bowel decompensation was done.
Alvimopan for prevention of postoperative paralytic ileus in radical cystectomy patients: A cost-effectiveness analysis.
Postoperative paralytic ileus usually involves the stomach for the first 48 hours after open abdominal surgery [31].
Taking into consideration the history, the examination and the investigation results (especially the abdominal radiograph), a diagnosis of paralytic ileus was made and we decided to continue supportive care after excluding all the causes that might lead to the development of ileus.
Among 567 consecutive spinal-cord-injury patients, eighty-seven episodes of gastrointestinal complications developed in 63 (11%) patients: paralytic ileus, gastric dilatation, Wilkie syndrome [30], peptic ulcer disease, and pancreatitis [29].
Phoebus had an enquiring mind, interests including publishing on the medical acute abdomen and paralytic ileus and a recent review on AIDS and the acute abdomen.
Plain film of the abdomen may show a loss of retroperitoneal landmark (obliteration of the ipsilateral psoas shadow or renal outline), stone, and signs of paralytic ileus. However, most of these findings are nonspecific and bowel gas may obscure these findings.
The patient had a colostomy for 3 months, then developed paralytic ileus, small bowel obstruction, and incisional hernias.
Dr Subhash Kala, who was attending on her, said Gayatri Devi was suffering from paralytic ileus. This is a condition when one's intestines don't move.
The clinical signs of SBO are difficult to distinguish from local or generalised paralytic ileus; therefore an early radiological diagnosis is very important.
The bowel becomes silent as peristalsis stops and paralytic ileus develops (Kinney, Dunbar, Brooks-Brunn, & Vitello-Cicciu, 1998).