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Vilz TO
; Stoffels B
; Strassburg C
; Schild HH
; Kalff JC
Dtsch Arztebl Int
2017[Jul]; 114
(29-30
): 508-518
PMID28818187
show ga
BACKGROUND: Ileus is one of the more common suspected diagnoses in everyday
clinical practice. The term can refer either to mechanical or to functional
ileus. Any physician who takes care of patients can be confronted with these
entities; thus, all should be familiar with them and competent in their
management. METHODS: Recommendations are summarized for the diagnostic evaluation
and treatment of ileus of various causes on the basis of a selective literature
review. RESULTS: The manifestations of ileus and its degree of severity generally
depend on the site of blockage. The rule until recently was that a patient with
suspected mechanical ileus should be taken to surgery within 12 hours; today,
however, ileus-particularly of the small bowel-can often be successfully treated
conservatively. Likewise, functional ileus only rarely requires surgery:
supportive measures, depending on the etiology, usually suffice. CONCLUSION:
Proper treatment depends on the timely determination of the pathogenesis
(mechanical versus functional) and on close interdisciplinary collaboration. A
special challenge is posed by patients with peritoneal involvement with cancer
who present with symptoms of ileus, in whom a clear distinction between
mechanical and functional causation cannot always be drawn.
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