ileus obstruction
DESCRIPTION
Definition, sign n symptom, diagnosis and managementTRANSCRIPT
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