Gastroenterology MCQ Answer 20

Answer: b

The term ileus reflects the underlying alterations in motility of the gastrointestinal tract, leading to functional obstruction. From a practical standpoint, ileus represents the interval between abdominal exploration and the reappearance of flatus and bowel movements. Distinguishing a normal postoperative ileus and the prolonged course of a “paralytic” ileus is based primarily on the time since operation and the clinical circumstances. Besides the location of the previous operation (upper abdominal, lower abdominal, pelvic., the nature of the previous operation and the findings may also contribute. Peritonitis or spillage of noxious material leads to an increase in the delay of return of normal bowel function. Distinguishing a paralytic ileus from mechanical obstruction can oftentimes be difficult. Abdominal x-rays in a postoperative ileus should reveal gas in segments of both the small and large bowel. Upper GI contrast or CT scan may also be helpful. Early postoperative obstruction is uncommon and is particularly rare for upper abdominal surgery, with most cases occurring after surgery of the colon, particularly abdominal perineal resection. There has been little success in the use of prokinetic agents to shorten recovery times after lower abdominal procedures. The use of intravenous patient controlled analgesia may delay the recovery of postoperative ileus when compared to the IM route of narcotic administration.

Category: Gastroenterology MCQs