Prolonged postoperative ileus is best treated by?
Most patients developed transient ileus after a major abdominal operation. Most of these resolve within 3 to 5 days. Condition like extensive operative manipulation, major small bowel injury, heavy narcotic use, intra abdominal infection and pancreatitis- can prolong the ileum to 5 to 7 days. Ileus prolonged beyond this period is viewed with suspicion. Management of postoperative ileus The essence of treatment is prevention, with the use of nasogastric suction and restriction of oral intake until bowel sounds and passage of flatus return. Electrolyte abnormality, if any is corrected. A battery of laboratory tests are conducted to look for primary causes. which, if found is treated. "If paralytic ileus is prolonged and threatens life, a laparotomy should be considered to exclude a hidden cause and facilitate bowel decompression" Ref: Bailey & Love 25/e, Page 1201.
Long tube inseion
Calcium pantothenate
Laparotomy and exploration
Peristaltic stimulants