ILEUS OBSTRUCTIONAbdul Mughni Rozy

Surgery Dept. Medical Faculty of Diponegoro University

www.undip.ac.id

the bolus can not advance to the rectum. After suffering tissue of the intestinal wall,

peforasi peritonitis

ILEUS OBSTRUCTION

Often the symptoms are uncharacteristic early.

a detailed history and careful examination of the patient are essential

Abdominal pain of unknown origin obscure and require, especially as infants or the elderly, a diagnostic management.

Ileus Symptoms

The following symptoms may occur alone or in combination, depending on the exact location of bowel obstruction.

Abdominal cramps or “colicky” high intensity Vomiting, possibly vomiting stool Very tense and distended abdomen (meteorism) No stool and gas Peristaltic movements strengthened, audible

and visible

Ileus Symptoms in case of mechanical ileus

Abdominal pain, especially after meals Nausea and vomiting Impairment of general condition Soft belly, distended with gas; in

inflammatory stomach becomes stretched and hardens

Absence of bowel sounds

Ileus Symptoms in functional ileus

Abdominal pain of sudden onset, colicky, high intensity

Vomiting Pallor, cold sweats The child is restless and anxious Period of calm followed by the reappearance of pain Lack of bowel movements, sometimes bloody

mucus removal Swollen abdomen

Ileus Symptoms of intussusception in infants

history of symptoms Questioning about medical history (eg, gastric

ulcers, inflammation of the intestine); information on the kind of pain Can Be very

useful for diagnosis, eg. if the pain is kind of stings, sudden onset,

felt Mainly in the abdomen or lower the abdomen, etc. .. Information on the color and Consistency of stools, as well as data on vomiting, can Be invaluable for the physician.

Ileus Diagnosis

Palpation: wall tension, bread is palpation Auscultation: bowel sounds metallic, no

noise DRE: return the index of the hand history

doctor palpates the terminal portion of the intestine (rectum)

Physical Examination

Radiography of the abdomen, with contrast Possibly Air fluid lever Hearing bone C - loop, volvulus Coffe bean appearence volvulus sigmoid

Ultrasound Target / donat Sign Invagination

Blood tests: red blood cells, white blood cells, hemoglobin, platelets, inflammation parameters

CT

Lab. Study

Abdominal X-Rays AP and LLD View

Air Fluid Level

USG

Target Sign

Infuse line maintenance or rehydration

Decompression Inserting NGT Inserting Rectal Tube Inserting Urine Catheter

Consult to Surgeon Laparotomy exploration

Management