Presentation
Recent hysterectomy and bilateral salpingo oophorectomy about 5 days ago. Referred for abdominal pain and distension.
Patient Data
Post-operative changes as surgical clips are seen in the pelvis due to recent trans abdominal hysterectomy and bilateral salpingo oophorectomy.
Diffuse gaseous dilatation in small and large bowel loops with air-fluid levels on erect image regarding recent surgery consistent with paralytic ileus.
Case Discussion
Paralytic ileus is the failure of passage of enteric contents through the small and large bowel loops due to paralysis of intestinal motility and not a mechanical obstruction.
Some degree of ileus is an expected finding after abdominopelvic surgery and routine conventional recovery times have been reported up to 72 hours. Prolonged postoperative ileus for more than 72 hours has been termed "paralytic" ileus by some and operative difficulty, operation more than 3 hours, bowel handling, drop in hematocrit levels, the need of a transfusion, and lack of mobility after operation are common risk factors for a long-standing post-surgical ileus.
Sometimes a prolonged postoperative paralytic ileus is concerned for small bowel obstruction, bowel perforation, peritonitis, and intra-abdominal abscess and needs more evaluations.
Unable to process the form. Check for errors and try again.