Paralytic ileus

pathophysiology of paralytic ileus, its causes, treatments.

1. PARALYTIC ILEUS By: Syed Mohammad Arish ayub American University of Barbados

2. WHAT IS PARALYTIC ILEUS 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 stimuli to 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

4. CAUSES Medication that causes paralytic 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

5. Symptoms Abdominal cramping Appetite loss Constipation Inability to pass gas Stomach swelling Nausea Vomiting

6. Diagnosed X-ray CT scan Ultrasound

7. treatment Putting the patient 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.

8. 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_Orthopaedic_Patient.6.aspx https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2501703/

9. THANK YOU