Document Detail

Postoperative ileus: a review.
MedLine Citation:
PMID:  14978625     Owner:  NLM     Status:  MEDLINE    
PURPOSE: Postoperatively, some patients experience a prolonged inhibition of coordinated bowel activity, which causes accumulation of secretions and gas, resulting in nausea, vomiting, abdominal distension, and pain. This prolonged inhibition can take days or weeks to resolve and often is referred to as postoperative paralytic ileus lasting more than three days after surgery. This article reviews the etiology, pathophysiology, and treatment options of postoperative ileus. METHODS: The relevant literature from 1965 to 2003 was identified and reviewed using MEDLINE database of the U.S. Medical Library of Medicine. Both retrospective and prospective studies were included in this review. RESULTS: The pathophysiology of postoperative ileus is multifactorial. The duration of postoperative ileus correlates with the degree of surgical trauma and is most extensive after colonic surgery. However, postoperative ileus can develop after all types of surgery including extraperitoneal surgery. A variety of treatment options have been used to decrease the duration of postoperative ileus. However, it is difficult to compare these studies because of small sample sizes and differences in operations performed, anesthesia protocols provided both intraoperatively and postoperatively, patient comorbidities, and in the measured end points, such as the time to the presence of bowel sounds, flatus, or bowel movements, tolerance of solid food, or discharge from the hospital. However, despite these drawbacks, some conclusions can be made. CONCLUSIONS: Paralytic postoperative ileus continues to be a significant problem after abdominal and other types of surgery. The etiology is multifactorial and is best treated with a combination of different approaches. Currently, the important factors that could effect the duration and recovery from postoperative ileus include limitation of narcotic use by substituting alternative medications such as nonsteroidals and placing a thoracic epidural with local anesthetic when possible. The selective use of nasogastric decompression and correction of electrolyte imbalances also are important factors to consider.
Mirza K Baig; Steven D Wexner
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Retracted Publication; Review     Date:  2004-02-25
Journal Detail:
Title:  Diseases of the colon and rectum     Volume:  47     ISSN:  0012-3706     ISO Abbreviation:  Dis. Colon Rectum     Publication Date:  2004 Apr 
Date Detail:
Created Date:  2004-03-30     Completed Date:  2004-04-21     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0372764     Medline TA:  Dis Colon Rectum     Country:  United States    
Other Details:
Languages:  eng     Pagination:  516-26     Citation Subset:  IM    
Department of Colorectal Surgery, Cleveland Clinic Florida, Weston, Florida 33331, USA.
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MeSH Terms
Anesthesia, Local
Digestive System Surgical Procedures / adverse effects*
Gastrointestinal Motility
Intestinal Pseudo-Obstruction* / etiology,  physiopathology,  therapy
Narcotics / adverse effects,  therapeutic use
Postoperative Complications*
Risk Factors
Severity of Illness Index
Reg. No./Substance:
0/Electrolytes; 0/Narcotics
Retraction In:
Dis Colon Rectum. 2005 Oct;48(10):1983   [PMID:  16132475 ]
Wexner SD. Dis Colon Rectum. 2005 Oct;48(10):1983   [PMID:  16132474 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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