Prologed Post-op ileus is best treated by –
Correct Answer: Laporotomy and exploration
Description: Most patients develop a transient ileus after a major abdominal operation. Most of these cases resolve within 3 to 5 days.
Conditions like-extensive operative manipulation, major small bowel injury, heavy narcotic use, intraabdominal infection and pancreatitis - can prolong the ileus to 5 to 7 days. Ileus prolnged beyond this period is viewed with suspicion.
Management of post op. ileus
The essence of treatment is prevention, with the use of nasogastric suction and restriction of oral intake until bowel sounds and passage of flatus return.
Electrolyte abnormality, if any is corrected.
A battery of laboratory tests are conducted to look for primary cause, which if found is treated.
"If paralytic ileus is prolonged and threatens life, a laparotomy should be considered to exclude a hidden cause and facilitate bowel decompression" - Bailey
Category:
Surgery
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