How can you tell the difference between ileus and obstruction?
Nausea, abdominal pain, bloating with vomiting, abdominal distention and obstipation being accompanying symptoms. Classically paralytic ileus is suggested by hypoactive bowel sounds whereas small bowel obstruction is described with rushes and bowel sounds consistent with peristalsis against the obstruction.
What is the best imaging for bowel obstruction?
Multidetector CT is the single best imaging tool for suspected SBO. Multidetector CT has a sensitivity and specificity of 95% for the diagnosis of high-grade SBO and is less accurate in partial obstruction (4,6–8).
What are the key differences between a functional vs mechanical ileus?
Unlike mechanical ileus, functional ileus is not due to a process obstructing the lumen of the bowel and impeding the passage of its contents, but rather to reduced contraction of the smooth muscle of the bowel wall.
How can you distinguish between mechanical and functional obstruction?
There are two types of small bowel obstruction:
- functional — there is no physical blockage, however, the bowels are not moving food through the digestive tract.
- mechanical — there is a blockage preventing the movement of food.
How do you manage ileus?
Nonsteroidal anti-inflammatory drug therapy may improve postoperative ileus by allowing the clinician to reduce the amount of opioid given by 20% to 30%. An additional benefit on bowel motility may be derived from the anti-inflammatory properties of nonsteroidal anti-inflammatory drugs.
What is the treatment for an ileus?
Ileus Treatment Your doctor might suggest: No food or fluids by mouth for 24 to 72 hours. Your doctor may also stop or cut back on strong pain relievers (opioid analgesics) or other medications that may be causing your symptoms. IV fluids to help correct any electrolyte imbalance.
What does ileus look like on CT?
Findings on a CT scan diagnostic of postoperative ileus include multiple air–fluid levels throughout the abdomen, elevated diaphragm, and dilation of both large and small intestine with no evidence of mechanical obstruction.
What is ileus of the bowel?
Ileus is a temporary arrest of intestinal peristalsis. It occurs most commonly after abdominal surgery, particularly when the intestines have been manipulated. Symptoms are nausea, vomiting, and vague abdominal discomfort.
What is the difference between ileus and mechanical obstruction?
• Generalized adynamic ileus affects all loops of large and small bowel and frequently the stomach. Mechanical obstruction is the other main category of abnormal bowel gas pattern.
How is localized ileus differentiated from small bowel obstruction?
A combination of the clinical and laboratory findings and CT scanning of the abdomen that demonstrates the underlying pathology should differentiate localized ileus from small bowel obstruction. • In a generalized adynamic ileus, the entire bowel is aperistaltic or hypoperistaltic.
Which findings on radiographic imaging are characteristic of ileus?
Findings on radiographic imaging include: dilated large and small bowel and distal/rectal air Resolution of ileus is signaled clinically by return of bowel sounds, passage of flatus, and bowel movements
What are the different types of ileus?
Abnormal Gas Patterns 1 • Localized ileus (also called sentinel loops ) affects only one or two loops of (usually small) bowel. 2 • Generalized adynamic ileus affects all loops of large and small bowel and frequently the stomach. 3 • Small bowel obstruction (frequently abbreviated SBO). 4 • Large bowel obstruction (frequently abbreviated LBO).