Paralytic ileus

Paralytic ileus
Paralytic ileus
Paralytic ileus is a state of atony of the intestine.

Clinical features,
        - Abdominal distension without any pain
        - Vomiting (Effortless)
        - Absolute constipation
        - No platus

        - Sepsis of Peritonitis
        - Hypokalaemia (reduced K ion)
        - Uremia
        - Diabetic coma
        - Excessive bowel handling
        - Abdominal trouma
        - Prolong hypotension
        - Prolong pypoxia
        - Immoilization
        - Opioid drugs

History and investigations for managements

- Duration
        if more than 3 to 5 day, mechanical cause

- Bowel sounds
        if silent, diagnostic for paralytic ileus
        if noicy, mechanical obstruction

- Pain
        if positive (+), mechanical obstruction
        if negative (-) paralytic ileus

- Timing

- X- Ray
        if localized loop of distention without gas Shadow, mechanical obstruction
        if diffuse distension with sags shadows, paralytic ileus


Prophylactic before surgery
        - Correct biochemical imbalance
        - Gently bowel handling during surgery
In established case
        - NG tube to prevent gaseous distension
        - Nill by mouth
        - Correct electrolyte imbalance
        - Drugs, morality stimulant such as metoclopramide together with erythromycine

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