Ileus

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Última revisão: 25 Set 2025
Última atualização: 22 Abr 2024

Resumo

Определение

Анамнез и осмотр

Ключевые диагностические факторы

  • presence of risk factors
  • nausea and vomiting
  • abdominal distention or tenderness
  • no features of mechanical obstruction or peritoneal inflammation (e.g., abdominal hernia, peritoneal signs)
Полная информация

Другие диагностические факторы

  • obstipation (absolute constipation)
  • discomfort and abdominal pain
  • decreased or hypoactive bowel sounds
  • hypovolaemia
Полная информация

Факторы риска

  • abdominal surgery
  • acute/systemic illness (e.g., myocardial infarction, pneumonia, acute cholecystitis, pancreatitis, sepsis, multi-organ trauma)
  • non-abdominal surgery
  • electrolyte imbalance
  • opioid analgesics, anticholinergics, or anaesthetic gases
  • comorbidities (e.g., diabetes mellitus, cardiovascular insufficiency, Chagas disease, scleroderma)
Полная информация

Диагностические исследования

Исследования, которые показаны в первую очередь

  • FBC
  • serum electrolytes
  • serum magnesium
  • urea and creatinine
  • arterial blood gases
  • abdomen and pelvis CT scan (with intravenous contrast and oral water-soluble contrast)
Полная информация

Исследования, проведение которых нужно рассмотреть

  • serum LFTs
  • serum lipase or amylase
  • small bowel series with oral water-soluble contrast
  • gastric emptying study
Полная информация

Алгоритм лечения

Острый

postoperative ileus

non-surgical cause

ПРОДОЛЖЕНИЕ

ileus lasting 4 days or longer post-surgery (prolonged ileus)

Составители

Эксперты-консультанты

John Abercrombie, FRCS

General and Colorectal Surgeon

Queen's Medical Centre

Nottingham

UK

Раскрытие информации

JA is a member of the Council of The Royal College of Surgeons of England and Clinical Lead for General Surgery, Getting It Right First Time. JA provides expert advice regarding suitability of surgical treatments for Spire Healthcare.

Выражение благодарностей

BMJ Best Practice would like to gratefully acknowledge the previous expert contributor, whose work has been retained in parts of the content:

Steven D. Wexner MD, PhD (Hon), FACS, FRCS, FRCS (Ed), FRCSI (Hon)

Director, Digestive Disease Center

Professor and Chair, Department of Colorectal Surgery

Cleveland Clinic

Weston

FL

Раскрытие информации

SDW has received consulting fees, stock options, and royalties from the following companies. These relationships are ongoing. Consulting - Intuitive Surgical, Karl Storz Endoscopy America, Medtronic, TiGenix. Royalties - Covidien, Intuitive Surgical, Karl Storz Endoscopy America, Unique Surgical Innovations. There are no relevant disclosures to the submitted work.

Рецензенты

Michele Lucarotti, MD, FRCS

Consultant General & Colorectal Surgeon

Gloucestershire Royal Hospital

Gloucester

UK

Раскрытие информации

ML declares that she has no competing interests.

Stephen Chapman, MBChB, BSc(Hons), MRCS(Eng)

NIHR Doctoral Research Fellow

General Surgery Registrar

Leeds Institute of Medical Research

University of Leeds

Leeds

UK

Раскрытие информации

SC declares that he has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

Список литературы

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Основные статьи

Wattchow D, Heitmann P, Smolilo D, et al. Postoperative ileus - an ongoing conundrum. Neurogastroenterol Motil. 2021 May;33(5):e14046. Аннотация

Gustafsson UO, Scott MJ, Hubner M, et al. Guidelines for perioperative care in elective colorectal surgery: enhanced recovery after surgery (ERAS®) society recommendations: 2018. World J Surg. 2019 Mar;43(3):659-95.Полный текст  Аннотация

Association of Surgeons of Great Britain and Ireland; Royal College of Surgeons of England. Commissioning guide: emergency general surgery (acute abdominal pain). April 2014 [internet publication].Полный текст

Powell-Tuck J, Gosling P, Lobo DN, et al. British consensus guidelines on intravenous fluid therapy for adult surgical patients (GIFTASUP). March 2011 [internet publication].Полный текст

Статьи, указанные как источники

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
  • Ileus images
  • Отличия

    • Mechanical bowel obstruction
    • Pseudo-obstruction (Ogilvie's syndrome)
    • Gastroenteritis
    Больше Отличия
  • Рекомендации

    • Guidelines for perioperative care in elective colorectal surgery: Enhanced Recovery After Surgery (ERAS®) Society recommendation
    • Commissioning guide: emergency general surgery (acute abdominal pain)
    Больше Рекомендации
  • Vídeos

    Nasogastric tube insertion animated demonstration

    Больше Видео
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