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Paralytic ileus
Paralytic ileus is the inability of the intestines to conduct peristalsis, which can lead to obstruction. It is caused by stressful stimuli activating the sympathetic nervous system, decreasing peristalsis. Intraoperative manipulation may also cause nitric oxide release and smooth muscle relaxation, decreasing peristalsis. Common causes include medications, intestinal cancer, Crohn's disease, diverticulitis, and Parkinson's disease. Symptoms include abdominal cramping, appetite loss, constipation, inability to pass gas, stomach swelling, nausea, and vomiting. It is diagnosed using x-ray, CT scan, or ultrasound. Treatment involves putting the patient on a clear liquid diet, inserting a tube for relief, surgery, IV
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Paralytic ileus
- 1. PARALYTIC ILEUS By: SyedMohammad Arish ayub American University of Barbados
- 2. WHAT IS PARALYTICILEUS • It is the inability of the intestines to conduct peristalsis which can lead to obstruction. • Also known as functional bowel obstruction. • Most common form of non mechanical obstruction.
- 3. PATHOPHYSIOLOGY • Stressful stimulito the bowel activates sympathetic NS therefore decreasing peristalsis. • Intraoperative manipulation may cause nitric oxide to be released and this relaxes smooth muscles, decreasing peristalsis. • Obstruction of the intestine due to paralysis of the intestinal muscles
- 5. CAUSES Medication that causesparalytic ileus - • hydromorphone(Dilaudid) • morphine • oxycodone • tricyclic antidepressants, such as amitriptyline and imipramine intestinal cancer Crohn’s disease, which causes the intestinal walls to get thicker due to autoimmune inflammation diverticulitis Parkinson’s disease, which affects muscles and nerves in the intestines
- 6. SYMPTOMS • Abdominal cramping •Appetite loss • Constipation • Inability to pass gas • Stomach swelling • Nausea • Vomiting
- 7. DIAGNOSED • X-ray • CTscan • Ultrasound
- 8. TREATMENT • Putting thepatient on nothing by mouth status (NPO) • Inserting a tube in either the rectum or the nose for relief from abdominal swelling. • Surgery (e.g. laparotomy) • IV fluids to prevent dehydration • Medications such as Enemas, laxatives.
- 9. REFERENCES • https://www.medicinenet.com/script/main/art.asp?articlekey=7886 • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5569564/ •https://emedicine.medscape.com/article/2242141-overview • https://journals.lww.com/jaaos/Fulltext/2015/06000/Paralytic_Ileus_in_the_Orthopae dic_Patient.6.aspx • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2501703/
- 10.
Editor's Notes
- #3 Ileus means painful obstruction of ileum or any other parts of intestine. Paralytic means decreased in prestalsis.
- #4 May also occur after surgery and may occur due to inflammatory responses, electrolyte abnormality, thoracic or lumbar spinal fractures. May also alter the intestinal equilibrium, resulting in disorganized electrical activity and paralysis of intestinal muscles which decreases the peristalsis.
- #6 diverticulitis is inflammation or infection of small pouches called diverticula that develop along the walls of the intestines. Cause by use of opioids medications such as hydromorphone(Dilaudid) ,Morphine, oxycodone
- #7 Inability to pass gas because stool gets stuck in intestine because of decreased in peristaltic movement. Vomiting especially stool like content
- #9 A laparotomy is a surgical procedure involving a large incision through the abdominal wall to gain access into the abdominal cavity.