Ileus resident survival guide: Difference between revisions
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Untreated [[ileus]] can lead to [[intestine|intestinal]] [[ischemia|tissue ischemia]], which elevates the risk of [[Gastrointestinal perforation|perforation]] and subsequently life threatening peritonitis.<ref name="pmid12578422">{{cite journal| author=Luckey A, Livingston E, Taché Y| title=Mechanisms and treatment of postoperative ileus. | journal=Arch Surg | year= 2003 | volume= 138 | issue= 2 | pages= 206-14 | pmid=12578422 | doi=10.1001/archsurg.138.2.206 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12578422 }} </ref><ref name="pmid19399212">{{cite journal| author=Zeinali F, Stulberg JJ, Delaney CP| title=Pharmacological management of postoperative ileus. | journal=Can J Surg | year= 2009 | volume= 52 | issue= 2 | pages= 153-7 | pmid=19399212 | doi= | pmc=2663489 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19399212 }} </ref> | Untreated [[ileus]] can lead to [[intestine|intestinal]] [[ischemia|tissue ischemia]], which elevates the risk of [[Gastrointestinal perforation|perforation]] and subsequently life threatening peritonitis.<ref name="pmid12578422">{{cite journal| author=Luckey A, Livingston E, Taché Y| title=Mechanisms and treatment of postoperative ileus. | journal=Arch Surg | year= 2003 | volume= 138 | issue= 2 | pages= 206-14 | pmid=12578422 | doi=10.1001/archsurg.138.2.206 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12578422 }} </ref><ref name="pmid19399212">{{cite journal| author=Zeinali F, Stulberg JJ, Delaney CP| title=Pharmacological management of postoperative ileus. | journal=Can J Surg | year= 2009 | volume= 52 | issue= 2 | pages= 153-7 | pmid=19399212 | doi= | pmc=2663489 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19399212 }} </ref> | ||
===Common Causes=== | ===Common Causes of Functional Ileus=== | ||
*[[ileus|Reflectory ileus]] due to [[abdominal surgery|abdominal]], [[Pelvis|pelvic]] or retroperitoneal [[surgery|surgeries]]<ref name="pmid12578422">{{cite journal| author=Luckey A, Livingston E, Taché Y| title=Mechanisms and treatment of postoperative ileus. | journal=Arch Surg | year= 2003 | volume= 138 | issue= 2 | pages= 206-14 | pmid=12578422 | doi=10.1001/archsurg.138.2.206 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12578422 }} </ref> | *[[ileus|Reflectory ileus]] due to [[abdominal surgery|abdominal]], [[Pelvis|pelvic]] or retroperitoneal [[surgery|surgeries]]<ref name="pmid12578422">{{cite journal| author=Luckey A, Livingston E, Taché Y| title=Mechanisms and treatment of postoperative ileus. | journal=Arch Surg | year= 2003 | volume= 138 | issue= 2 | pages= 206-14 | pmid=12578422 | doi=10.1001/archsurg.138.2.206 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12578422 }} </ref> | ||
*[[Medication|Medications]] such as [[narcotic|narcotics]], [[Anticholinergic|anticholinergics]], [[calcium channel blocker|calcium channel blockers]] and [[Antipsychotic|antipsychotics]]<ref name="pmid19399212" /><ref name="pmid28818187">{{cite journal| author=Vilz TO, Stoffels B, Strassburg C, Schild HH, Kalff JC| title=Ileus in Adults. | journal=Dtsch Arztebl Int | year= 2017 | volume= 114 | issue= 29-30 | pages= 508-518 | pmid=28818187 | doi=10.3238/arztebl.2017.0508 | pmc=5569564 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28818187 }} </ref> | *[[Medication|Medications]] such as [[narcotic|narcotics]], [[Anticholinergic|anticholinergics]], [[calcium channel blocker|calcium channel blockers]] and [[Antipsychotic|antipsychotics]]<ref name="pmid19399212" /><ref name="pmid28818187">{{cite journal| author=Vilz TO, Stoffels B, Strassburg C, Schild HH, Kalff JC| title=Ileus in Adults. | journal=Dtsch Arztebl Int | year= 2017 | volume= 114 | issue= 29-30 | pages= 508-518 | pmid=28818187 | doi=10.3238/arztebl.2017.0508 | pmc=5569564 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28818187 }} </ref> | ||
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*[[Diabetes Mellitus]]<ref name="pmid28818187">{{cite journal| author=Vilz TO, Stoffels B, Strassburg C, Schild HH, Kalff JC| title=Ileus in Adults. | journal=Dtsch Arztebl Int | year= 2017 | volume= 114 | issue= 29-30 | pages= 508-518 | pmid=28818187 | doi=10.3238/arztebl.2017.0508 | pmc=5569564 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28818187 }} </ref> | *[[Diabetes Mellitus]]<ref name="pmid28818187">{{cite journal| author=Vilz TO, Stoffels B, Strassburg C, Schild HH, Kalff JC| title=Ileus in Adults. | journal=Dtsch Arztebl Int | year= 2017 | volume= 114 | issue= 29-30 | pages= 508-518 | pmid=28818187 | doi=10.3238/arztebl.2017.0508 | pmc=5569564 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28818187 }} </ref> | ||
*[[intestine|Intestinal]] [[Shock|hypoperfusion]]<ref name="pmid28818187">{{cite journal| author=Vilz TO, Stoffels B, Strassburg C, Schild HH, Kalff JC| title=Ileus in Adults. | journal=Dtsch Arztebl Int | year= 2017 | volume= 114 | issue= 29-30 | pages= 508-518 | pmid=28818187 | doi=10.3238/arztebl.2017.0508 | pmc=5569564 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28818187 }} </ref> | *[[intestine|Intestinal]] [[Shock|hypoperfusion]]<ref name="pmid28818187">{{cite journal| author=Vilz TO, Stoffels B, Strassburg C, Schild HH, Kalff JC| title=Ileus in Adults. | journal=Dtsch Arztebl Int | year= 2017 | volume= 114 | issue= 29-30 | pages= 508-518 | pmid=28818187 | doi=10.3238/arztebl.2017.0508 | pmc=5569564 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28818187 }} </ref> | ||
===Common Causes of Mechanical Ileus=== | |||
*[[tumor|Tumors]]<ref name="pmid28818187">{{cite journal| author=Vilz TO, Stoffels B, Strassburg C, Schild HH, Kalff JC| title=Ileus in Adults. | journal=Dtsch Arztebl Int | year= 2017 | volume= 114 | issue= 29-30 | pages= 508-518 | pmid=28818187 | doi=10.3238/arztebl.2017.0508 | pmc=5569564 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28818187 }} </ref> | |||
*[[Hernia]] | |||
*[[infection|Infections]] or [[inflammation|inflammations]] that affect the [[Intestine|bowel wall]] (eg, [[diverticulitis]]])<ref name="pmid28818187">{{cite journal| author=Vilz TO, Stoffels B, Strassburg C, Schild HH, Kalff JC| title=Ileus in Adults. | journal=Dtsch Arztebl Int | year= 2017 | volume= 114 | issue= 29-30 | pages= 508-518 | pmid=28818187 | doi=10.3238/arztebl.2017.0508 | pmc=5569564 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28818187 }} </ref> | |||
*[[Fecal impaction]]<ref name="pmid28818187">{{cite journal| author=Vilz TO, Stoffels B, Strassburg C, Schild HH, Kalff JC| title=Ileus in Adults. | journal=Dtsch Arztebl Int | year= 2017 | volume= 114 | issue= 29-30 | pages= 508-518 | pmid=28818187 | doi=10.3238/arztebl.2017.0508 | pmc=5569564 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28818187 }} </ref> | |||
*[[Intussusception]] | |||
*[[Adhesion (medicine)|Adhesion]] (eg, due to a previous [[surgery]])<ref name="pmid28818187">{{cite journal| author=Vilz TO, Stoffels B, Strassburg C, Schild HH, Kalff JC| title=Ileus in Adults. | journal=Dtsch Arztebl Int | year= 2017 | volume= 114 | issue= 29-30 | pages= 508-518 | pmid=28818187 | doi=10.3238/arztebl.2017.0508 | pmc=5569564 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28818187 }} </ref> | |||
*[[Volvulus]] (eg, [[Sigmoid colon|sigmoid]] [[volvulus]]) | |||
==Diagnosis== | ==Diagnosis== | ||
Revision as of 18:38, 23 September 2020
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:
Synonyms and keywords:
Overview
Ileus is defined as reduction in intestinal motility and it can be divided into mechanical or functional ileus. Reduction or cessation of intestinal peristalsis prevent effective transmission of intestinal content which leads to constipation and abdominal distension.
Causes
Life Threatening Causes
Untreated ileus can lead to intestinal tissue ischemia, which elevates the risk of perforation and subsequently life threatening peritonitis.[1][2]
Common Causes of Functional Ileus
- Reflectory ileus due to abdominal, pelvic or retroperitoneal surgeries[1]
- Medications such as narcotics, anticholinergics, calcium channel blockers and antipsychotics[2][3]
- General anaesthesia[1]
- Hypokalemia[3]
- Diabetes Mellitus[3]
- Intestinal hypoperfusion[3]
Common Causes of Mechanical Ileus
- Tumors[3]
- Hernia
- Infections or inflammations that affect the bowel wall (eg, diverticulitis])[3]
- Fecal impaction[3]
- Intussusception
- Adhesion (eg, due to a previous surgery)[3]
- Volvulus (eg, sigmoid volvulus)
Diagnosis
Shown below is an algorithm summarizing the diagnosis of [[disease name]] according the the [...] guidelines.
| Column heading 1 | Column heading 2 | Column heading 3 |
|---|---|---|
| Row heading 1 | Cell 2 | Cell 3 |
| Row heading A | Cell B | Cell C |
Treatment
Shown below is an algorithm summarizing the treatment of [[disease name]] according the the [...] guidelines.
Do's
- The content in this section is in bullet points.
Don'ts
- The content in this section is in bullet points.
References
- ↑ 1.0 1.1 1.2 Luckey A, Livingston E, Taché Y (2003). "Mechanisms and treatment of postoperative ileus". Arch Surg. 138 (2): 206–14. doi:10.1001/archsurg.138.2.206. PMID 12578422.
- ↑ 2.0 2.1 Zeinali F, Stulberg JJ, Delaney CP (2009). "Pharmacological management of postoperative ileus". Can J Surg. 52 (2): 153–7. PMC 2663489. PMID 19399212.
- ↑ 3.0 3.1 3.2 3.3 3.4 3.5 3.6 3.7 Vilz TO, Stoffels B, Strassburg C, Schild HH, Kalff JC (2017). "Ileus in Adults". Dtsch Arztebl Int. 114 (29–30): 508–518. doi:10.3238/arztebl.2017.0508. PMC 5569564. PMID 28818187.