Ileus

Ileus:  temporary stop for small intestine

psedo-obstruction is the functional obstruction in large bowels and which is different for ileus and less common. 

Causes of ileus:  Things that make the bowel unhappy.

- injury

- handing during surgery

- electorolyte imbalances ( hypokalemia, hyponatremia )

- accumulation of food in bowel: causing a bowel distension => venus compression => decrease oxygenation => decrease in peristalsis

 

Signs and symptoms

- vomiting (green bilious vomiting)

- abdominal distention

- diffuse abdominal pain

- absolute constipation

- lack of flatuence

- absent bowel sounds

Types of Obstruction

Mechanical Obstruction

 

adhesion	tumors	intusussception	hernia	volvulous
- most common cause of mechanical obstruction is post operative adheson - adhesion are fibrous billes btw bowel segment. - cause extrinsic compensatio of the bowel.	- colorectal cancer is a common and lethal disease. - risk factors include age, family, obesity, inflammatory bowel disease and certain diets.  - self-explanatory tumor can grow so large that can cause an obstruction.	- rare in adults.  - 1~5% of mechanical bowel obstruction is a result of intussusception.  - common site of intussusception is the ileocecal valve.	- defined as a protrusion bulge or projection of an organ or a part of an organ through the body wall that normally contains  it.  - hernia can be internal  or external	- twisting of a segments of the intestine around a fixed point.  - common sites of volvulus include the cecum and sigmoid.  - small bowel adhesion can lead to a volvulus.

Psedo Obstruction

psedo obstruction is the psedo false obsstruction. 

Myopathy / Neuropathy	Hirschsprung disease
Myopathy => no movoment peristaltic contraction => obstruction Neuropathy => no innervation of the smouth muscles => abnormal movement => obstruction	- congenial condition - nerves are missing at the distal end of the colon => no/abnormal peritalsis => bowl obstruction

Management

- treat the underlying cuase

- supportive care

• nil by mouth (NPO)/ sips of water
• NG tube (removal of residual things in small bowl and gas)
• IV fluids (dehytratjion/ electrolyte imbalances)

- mobilisaton

- Total Parental Nurition (TPN)