Normal peristalsis stops - can be referred to as paralytic ileus or adynamic ileus

Pseudo-obstruction is a term used to describe a functional obstruction of the large bowel, where patients present with intestinal obstruction, but no mechanical cause is found. This is less common than ileus affecting the small bowel.

Causes

There is a long list of things that can make the bowel unhappy, leading to ileus. Common causes are:

• Injury to the bowel
• Handling of the bowel during surgery
• Inflammation or infection in, or nearby, the bowel (e.g., peritonitis, appendicitis, pancreatitis or pneumonia)
• Electrolyte imbalance (e.g., hypokalaemia or hyponatraemia)

The most common time you will see ileus is a few days following abdominal surgery and can cause hypovolaemia and electrolyte disturbances BEFORE the nausea and vomitting become apparent. This usually resolves with supportive care within a few days.

PC

The signs and symptoms are akin to bowel obstruction, with:

• Vomiting (particularly green bilious vomiting)
• Abdominal distention
• Diffuse abdominal pain
• Absolute constipation and lack of flatulence
• Absent bowel sounds (as opposed to the “tinkling” bowel sounds of mechanical obstruction)

Investigations