This document discusses ileus obstruction, which occurs when the bowels cannot move food and waste normally due to a blockage. Symptoms vary depending on the location of the blockage but can include abdominal pain, vomiting, distension, and lack of bowel movements. Diagnosis involves physical examination, imaging tests like abdominal x-rays and ultrasound, and lab tests. Treatment focuses on rehydration, decompression of the bowels by inserting tubes, and consultation with surgeons who may perform exploratory laparotomy if needed.

1. ILEUS OBSTRUCTION
Abdul Mughni Rozy
Surgery Dept. Medical Faculty of Diponegoro University
www.undip.ac.id

2.  the bolus can not advance to the rectum.
 After suffering tissue of the intestinal wall, 
peforasi  peritonitis
ILEUS OBSTRUCTION

3.  Often the symptoms are uncharacteristic early.
 a detailed history and careful examination of the
patient are essential
 Abdominal pain of unknown origin obscure and
require, especially as infants or the elderly, a
diagnostic management.
Ileus Symptoms

4.  The following symptoms may occur alone or in
combination, depending on the exact location of
bowel obstruction.
 Abdominal cramps or “colicky” high intensity
 Vomiting, possibly vomiting stool
 Very tense and distended abdomen (meteorism)
 No stool and gas
 Peristaltic movements strengthened, audible and
visible
Ileus Symptoms in case of
mechanical ileus

5.  Abdominal pain, especially after meals
 Nausea and vomiting
 Impairment of general condition
 Soft belly, distended with gas; in inflammatory
stomach becomes stretched and hardens
 Absence of bowel sounds
Ileus Symptoms in functional ileus

6.  Abdominal pain of sudden onset, colicky, high intensity
 Vomiting
 Pallor, cold sweats
 The child is restless and anxious
 Period of calm followed by the reappearance of pain
 Lack of bowel movements, sometimes bloody mucus
removal
 Swollen abdomen
Ileus Symptoms of intussusception
in infants

7.  history of symptoms
 Questioning about medical history (eg, gastric ulcers,
inflammation of the intestine);
 information on the kind of pain Can Be very useful for
diagnosis, eg. if the pain is kind of stings, sudden onset,
 felt Mainly in the abdomen or lower the abdomen, etc. ..
Information on the color and Consistency of stools, as well
as data on vomiting, can Be invaluable for the physician.
Ileus Diagnosis

8.  Palpation: wall tension, bread is palpation
 Auscultation: bowel sounds metallic, no noise
 DRE: return the index of the hand history doctor
palpates the terminal portion of the intestine
(rectum)
Physical Examination

9.  Radiography of the abdomen, with contrast Possibly
 Air fluid lever
 Hearing bone
 C - loop, volvulus
 Coffe bean appearence  volvulus sigmoid
 Ultrasound
 Target / donat Sign  Invagination
 Blood tests: red blood cells, white blood cells, hemoglobin,
platelets, inflammation parameters
 CT
Lab. Study

10. Abdominal X-Rays AP and LLD View
Air Fluid Level

11. USG
 Target
Sign

12.  Infuse line
 maintenance or rehydration
 Decompression
 Inserting NGT
 Inserting Rectal Tube
 Inserting Urine Catheter
 Consult to Surgeon
 Laparotomy exploration
Management