Ileus of the Colon

Syndrome of Intestinal Pseudo-obstruction

“…Undoubtedly, the fluid and electrolyte therapy played the major part in the patients' improvement, but it may be that the rapid and efficient deflation of the dilated bowel at laparotomy helped break a possible vicious circle. In reporting eight similar cases which they labelled " ileus of the colon," Morton et al (1960) described two patients in which the distended caecum ruptured and two others considered to be in imminent danger of caecal rupture. They point out the value of diagnostic barium-enema examinations, but stress its danger if perforation of the caecum is imminent.…”

Diastatic Perforation of the Cecum Without Distal Obstruction

“…Postoperatively, he was maintained on a respirator with endotracheal intubation for 24 hours, as is routine in this institution. He did well until April 18,1976 Lung scan revealed several small perfusion defects consistent with multiple small pulmonary emboli. Later in the day, he again complained of increasing abdominal distention and received another enema, with some relief.…”

Colonic ileus

“…B Barium enema study excludes possibility of mechanical obstruction. Cecal diameter measures 16 cm curs in patients with sepsis, shock, lead intoxication, morphine overdosage, ganglionic blocking agents, renal failure, or electrolyte imbalance: We have also encountered it following pelvic operation, including hysterectomy, caesarian section [5][6][7], and prostatic surgery.…”

“…Over 20 cases of cecal perforation in severe or protracted colonic ileus with a mortality rate of 43% have been described [5,7,11,12]. These were probably attributable to delay in recognition of the cecal necrosis as well as of the primary disease state.…”

“…Cecostomy was performed in two of our patients. When a short term of conservative therapy is unrewarding, or cecal distention reaches a 9 cm diameter, or right lower quadrant symptoms or findings develop, operative decompression by cecostomy has been advocated to prevent peritonitis [5,12,19].…”