PARALYTIC ILEUS (Functional Obstruction)
Paralytic ileus is the occurrence of intestinal blockage in the absence of an actual physical obstruction. This type of blockage is caused by a malfunction in the nerves and muscles in the intestine that impairs digestive movement.
Essentials of Diagnosis:-
• Continuous abdominal pain, distension, vomiting and constipation.
• History of precipitating factors, i.e. after surgery, peritonitis.
• Minimal abdominal tenderness and decreased or absent bowel sounds.
• X-ray evidence of gas and fluid in the bowel.
-Postoperative ileus responds to restriction of oral fluid intake. Severe and prolonged ileus requires nasogastric suction and IV fluids with complete restriction on oral intake. Potassium depletion in postoperative cases is often a cause for prolonged ileus and needs potassium supplement under proper ECG control.
-When conservative treatment fails surgical decompression with enterostomy or caecostomy may be done. If ileus is secondary to electrolyte imbalance, severe infection, pneumonitis, intra- abdominal/back injury, the ileus is managed as above plus treatment of the primary disease.