Ileus from a surgical viewpoint


Ileus is one of many forms of acute abdomen. It is characterized as a disruption of the normal propulsive ability of the gastrointestinal tract with distension of bowel and then perforation followed by peritonitis and sepsis. This algorithm allows you to diagnose and treat this condition. You will also learn about complications that can occur.

2017
vascular ileus
short bowel syndrome
superior mesenteric artery embolism
Published at: 25.5.2017

Review

Martin Man, MD
Chief Physician of Surgery, TGM Hospital, Hodonín, Czech Republic

Acute mesenteric artery occlusion is an acute abdomen with the worst prognosis. The sooner we diagnose it and indicate the surgical solution, the more we increase the patient's chance of survival. We must always think of an
vascular ileus when the abdominal pain is sudden and clinical findings poor in patients with cardiac arrhythmias (in the case of embolism) or in patients  with atherosclerosis (in the case of mesenteric thrombosis). Signs of peritoneal irritation are a late symptom of vascular ileus. Typical symptoms may be
overlaid by other symptoms, which may lead us to suspect a different acute condition. In this algorithm, it is well demonstrated how important it is in the case of an acute abdomen to repeatedly check and physically examine the patient and subsequently indicate the correct examinations and treatment.

Sources

PÁRAL, Jiří. Akutní mezenterální ischémie: Moderní diagnostika a léčba akutní ischemie střeva. Grada, 2012. ISBN 978-80-247-3996-0.

Acute Mesenteric Ischemia [online]. Medscape, 2016 [cit. 2017-04-17]. Retrieved from: http://emedicine.medscape.com/article/189146-overview

Guidelines for management of patients with a short bowel [online]. PubMed, 2006 [cit. 2017-04-17]. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2806687/

Predicting anastomotic disruption after emergent small bowel surgery. [online]. PubMed, 2006 [cit. 2017-04-17]. Retrieved from: https://www.ncbi.nlm.nih.gov/pubmed/16717468

Analgesia in patients with acute abdominal pain. [online]. PubMed, 2011 [cit. 2017-04-17]. Retrieved from: https://www.ncbi.nlm.nih.gov/pubmed/21249672

Acute Abdominal Pain: Manage Without Delay [online]. Medscape, 2013 [cit. 2017-04-17]. Retrieved from: http://www.medscape.com/viewarticle/808580_3

Evaluation and management of acute abdominal pain in the emergency department [online]. PubMed, 2012 [cit. 2017-04-17]. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3468117/

JINDROVÁ, Barbora, Martin STŘÍTESKÝ a Jan KUNSTÝŘ. Praktické postupy v anestezii. Praha: Grada, 2011. ISBN 978-80-247-3626-6.

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