Ver el código de «Ileus»

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==Background==

*Failure or insufficiency in the peristalsis movement of the gastrointestinal tract which normally moves GI contents from mouth to anus. 
*Thought to be caused by a disruption in either the neural and/or neuro-hormonal reflexes that normally regulate bowel motility. 
*Multiple causes possible - likely an inflammatory condition
**[[Special:MyLanguage/Opioid|Opioid]]-induced
**Post-operative (irritation +/- opioids)
**Electrolyte imbalance ([[Special:MyLanguage/hypokalemia|hypokalemia]], [[Special:MyLanguage/hypomagnesemia|hypomagnesemia]])
**Colonic pseudo-obstruction (aka [[Special:MyLanguage/Ogilvie's syndrome|Ogilvie's syndrome]])
**Gallstone ileus, [[Special:MyLanguage/pancreatitis|pancreatitis]]
*[[Special:MyLanguage/Peritonitis|Peritonitis]] (e.g. from infection, malignancy, trauma)
*[[Special:MyLanguage/Clostridium difficile|Clostridium difficile]] colitis
**[[Special:MyLanguage/Burns|Burns]], [[Special:MyLanguage/acute radiation syndrome|acute radiation syndrome]]
**Spastic ileus (rare: porphyria or lead poisoning)


==Clinical Features==

*[[Special:MyLanguage/Abdominal pain|Abdominal pain]]/distension
*[[Special:MyLanguage/Nausea/vomiting|Nausea/vomiting]], inability to tolerate PO/enteral feeding
*[[Special:MyLanguage/Constipation|Constipation]]
*Absent or hypoactive bowel sounds
*Can produce intestinal ischemia, intestinal perforation, abdominal compartment syndrome


==Differential Diagnosis==

*[[Special:MyLanguage/Small bowel obstruction|Small bowel obstruction]]
*See [[Special:MyLanguage/constipation|constipation]], [[Special:MyLanguage/abdominal pain|abdominal pain]]


==Evaluation==

*BMP, Mg
*[[Special:MyLanguage/Abdominal X-ray|Abdominal X-ray]]: air fluid levels, air in bowel, distended bowel
*Evaluate for underlying causes
*If concern for [[Special:MyLanguage/SBO|SBO]], CT abdomen


==Management==

*Treat underlying causes
*Avoid excessive [[Special:MyLanguage/IVF|IV fluids]] (bowel edema worsens ileus)
*Avoid [[Special:MyLanguage/opioids|opioids]]
*Pro-motility agents
**[[Special:MyLanguage/Metoclopramide|Metoclopramide]], [[Special:MyLanguage/erythromycin|erythromycin]]
*Opioid antagonist: methylnaltrexone
*[[Special:MyLanguage/Ogilvie's syndrome|Ogilvie's syndrome]]: [[Special:MyLanguage/Neostigmine|Neostigmine]] 2mg IV


==Disposition==


==See Also==

*[[Special:MyLanguage/Small bowel obstruction|Small bowel obstruction]]
*[[Special:MyLanguage/Toxic megacolon|Toxic megacolon]]



==External Links==


==References==

<references/>

[[Category:GI]]
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