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Alternative namesParalytic ileus; Intestinal volvulus; Bowel obstruction; Ileus; Pseudo-obstruction - intestinal
DefinitionIntestinal obstruction involves a partial or complete blockage of the bowel that results in the failure of the intestinal contents to pass through.
Causes, incidence, and risk factors
Obstruction of the bowel may be caused by ileus, in which the bowel doesn't function correctly but there is no "mechanical" (anatomic) problem, or by mechanical causes. Paralytic ileus, also called pseudo-obstruction, is one of the major causes of obstruction in infants and children.
The causes of paralytic ileus may include the following:
Paralytic ileus may lead to complications causing jaundice and electrolyte imbalances . In the newborn, paralytic ileus that is associated with destruction of the bowel wall (necrotizing enterocolitis) is life-threatening and may lead to infecting the blood and lungs ( pneumonia ) in infants.
In older children, gastroenteritis may be a cause of paralytic ileus, which is sometimes associated with peritonitis and a ruptured appendix.
Paralytic ileus is marked by abdominal distention , absent bowel sounds (no noise heard when listening to abdomen) and relatively little pain (as compared to mechanical obstruction).
Signs and tests
While listening to the abdomen with a stethoscope your health care provider may hear high-pitched bowel sounds at the onset of mechanical obstruction. If the obstruction has persisted for too long or the bowel has been significantly damaged, bowel sounds decrease, eventually becoming silent.
Early paralytic ileus is marked by decreased or absent bowel sound.
TreatmentThe objective of treatment is to decompress the intestine with suction, using a nasogastric tube inserted into the stomach or intestine. This will relieve abdominal distention and vomiting .
Surgery to relieve the obstruction may be necessary if decompression by nasogastric tube does not relieve the symptoms, or if tissue death is suspected.
Expectations (prognosis)The outcome varies with the cause of the obstruction.
Calling your health care providerCall your health care provider if persistent abdominal distention develops and you are unable to pass stool or gas, or if other symptoms of intestinal obstruction develop.
Prevention depends on the cause. Treatment of conditions (such as tumors and hernias) that are related to obstruction may reduce the risk.
Some causes of obstruction are not preventable.
Update Date: 11/7/2002Jenifer K. Lehrer, M.D., Department of Gastroenterology, Graduate Hospital, Philadelphia, PA, and Timothy Cruz, M.D., Department of Pediatrics, Kaiser Permanente, Los Angeles, CA. Review provided by VeriMed Healthcare Network.
Last updated: Tue, 06 Jan 2009 00:20:03 GMT