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Paralytic ileus, also called pseudo-obstruction, is one of the major causes of intestinal obstruction in infants and children. Causes of paralytic ileus may include:
Paralytic ileus, also called pseudo-obstruction, is one of the major causes of intestinal obstruction in infants and children. Causes of paralytic ileus may include:


*Bacteria or viruses that cause intestinal infections (gastroenteritis)
*Bacteria or viruses that cause intestinal infections ([[gastroenteritis]])
*Chemical, electrolyte, or mineral imbalances (such as decreased potassium levels)
*Chemical, electrolyte, or mineral imbalances (such as decreased potassium levels)
*Complications of abdominal surgery
*Complications of abdominal surgery
*Decreased blood supply to the intestines (mesenteric ischemia)
*Decreased blood supply to the intestines ([[mesenteric ischemia]])
*Infections inside the abdomen, such as appendicitis
*Infections inside the abdomen, such as [[appendicitis]]
*Kidney or lung disease
*Kidney or lung disease
*Use of certain medications, especially narcotics
*Use of certain medications, especially narcotics
Line 29: Line 29:
*Adhesions or scar tissue that forms after surgery
*Adhesions or scar tissue that forms after surgery
*Foreign bodies (eaten materials that block the intestines)
*Foreign bodies (eaten materials that block the intestines)
*Gallstones (rare)
*[[Gallstones]] (rare)
*Hernias
*[[Hernias]]
*Impacted stool
*Impacted stool
*Intussusception (telescoping of one segment of bowel into another)
*[[Intussusception]] (telescoping of one segment of bowel into another)
*Tumors blocking the intestines
*Tumors blocking the intestines
*Volvulus (twisted intestine)
*[[Volvulus]] (twisted intestine)


==What are the symptoms?==
==What are the symptoms?==
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*Abdominal pain and cramping
*Abdominal pain and cramping
*Breath odor
*Breath odor
*Constipation
*[[Constipation]]
*Diarrhea
*[[Diarrhea]]
*Inability to pass gas
*Inability to pass gas
*Vomiting
*[[Vomiting]]


==Diagnosis==
==Diagnosis==


During a physical exam, the health care provider may find bloating, tenderness, or hernias in the abdomen.
During a physical exam, the health care provider may find bloating, tenderness, or [[hernias]] in the abdomen.


Tests that show obstruction include:
Tests that show obstruction include:
Line 72: Line 72:


*Electrolyte (blood chemical and mineral) imbalances
*Electrolyte (blood chemical and mineral) imbalances
*Dehydration
*[[Dehydration]]
*Hole (perforation) in the intestine  
*Hole (perforation) in the intestine  
*Infection
*Infection
*Jaundice (yellowing of the skin and eyes)
*[[Jaundice]] (yellowing of the skin and eyes)


If the obstruction blocks the blood supply to the intestine, it may cause infection and tissue death (gangrene). Risks for tissue death are related to the cause of the blockage and how long it has been present. Hernias, volvulus, and intussusception carry a higher gangrene risk.  
If the obstruction blocks the blood supply to the intestine, it may cause infection and tissue death ([[gangrene]]). Risks for tissue death are related to the cause of the blockage and how long it has been present. Hernias, volvulus, and intussusception carry a higher gangrene risk.  


In a newborn, paralytic ileus that destroys the bowel wall (necrotizing enterocolitis) is life-threatening and may lead to blood and lung infections.
In a newborn, paralytic ileus that destroys the bowel wall ([[necrotizing enterocolitis]]) is life-threatening and may lead to blood and lung infections.


==When to seek urgent medical care?==
==When to seek urgent medical care?==
Line 91: Line 91:
==Prevention==
==Prevention==


Prevention depends on the cause. Treating conditions, such as tumors and hernias, that can lead to obstruction may reduce your risk of getting an obstruction.
Prevention depends on the cause. Treating conditions, such as [[tumors]] and hernias, that can lead to obstruction may reduce your risk of getting an obstruction.


Some causes of obstruction cannot be prevented.
Some causes of obstruction cannot be prevented.

Revision as of 00:32, 29 November 2012

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Ileus (patient information)

Overview

What are the symptoms?

What are the causes?

Diagnosis

When to seek urgent medical care?

Treatment options

Prevention

What to expect (Outlook/Prognosis)?

Possible complications

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Intestinal obstruction is a partial or complete blockage of the bowel that prevents the contents of the intestine from passing through.

What are the causes?

Obstruction of the bowel may due to:

  • A mechanical cause, which means something is in the way
  • Ileus, a condition in which the bowel doesn't work correctly but there is no structural problem

Paralytic ileus, also called pseudo-obstruction, is one of the major causes of intestinal obstruction in infants and children. Causes of paralytic ileus may include:

  • Bacteria or viruses that cause intestinal infections (gastroenteritis)
  • Chemical, electrolyte, or mineral imbalances (such as decreased potassium levels)
  • Complications of abdominal surgery
  • Decreased blood supply to the intestines (mesenteric ischemia)
  • Infections inside the abdomen, such as appendicitis
  • Kidney or lung disease
  • Use of certain medications, especially narcotics

Mechanical causes of intestinal obstruction may include:

  • Adhesions or scar tissue that forms after surgery
  • Foreign bodies (eaten materials that block the intestines)
  • Gallstones (rare)
  • Hernias
  • Impacted stool
  • Intussusception (telescoping of one segment of bowel into another)
  • Tumors blocking the intestines
  • Volvulus (twisted intestine)

What are the symptoms?

  • Abdominal swelling (distention)
  • Abdominal fullness, gas
  • Abdominal pain and cramping
  • Breath odor
  • Constipation
  • Diarrhea
  • Inability to pass gas
  • Vomiting

Diagnosis

During a physical exam, the health care provider may find bloating, tenderness, or hernias in the abdomen.

Tests that show obstruction include:

  • Abdominal CT scan
  • Abdominal x-ray
  • Barium enema
  • Upper GI and small bowel series

Treatment

Treatment involves placing a tube through the nose into the stomach or intestine to help relieve abdominal swelling (distention) and vomiting. Volvulus of the large bowel may be treated by passing a tube into the rectum.

Surgery may be needed to relieve the obstruction if the tube does not relieve the symptoms, or if there are signs of tissue death.

What to expect (Outlook/Prognosis)?

The outcome depends on the cause of the blockage. Most of the time the cause is easily treated.

Possible complications

Complications may include or may lead to:

  • Electrolyte (blood chemical and mineral) imbalances
  • Dehydration
  • Hole (perforation) in the intestine
  • Infection
  • Jaundice (yellowing of the skin and eyes)

If the obstruction blocks the blood supply to the intestine, it may cause infection and tissue death (gangrene). Risks for tissue death are related to the cause of the blockage and how long it has been present. Hernias, volvulus, and intussusception carry a higher gangrene risk.

In a newborn, paralytic ileus that destroys the bowel wall (necrotizing enterocolitis) is life-threatening and may lead to blood and lung infections.

When to seek urgent medical care?

Call your health care provider if you:

  • Cannot pass stool or gas
  • Have a swollen abdomen (distention) that does not go away
  • Keep vomiting

Prevention

Prevention depends on the cause. Treating conditions, such as tumors and hernias, that can lead to obstruction may reduce your risk of getting an obstruction.

Some causes of obstruction cannot be prevented.