Paralytic Ileus in the Orthopaedic Patient

Daniels, Alan H.; Ritterman, Scott A.; Rubin, Lee E.

doi:10.5435/jaaos-d-14-00162

Cited by 29 publications

(22 citation statements)

References 42 publications

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“…The relationship between early patient mobilization and POI was also evaluated in literature (5,37,38). Earlier walking might help to promote intestinal peristalsis, preventing the occurrence of intestinal adhesions, and at the same time contribute to the psychological recovery of patients.…”

Section: Other Risk Factors For Developing Poi and What Could We Domentioning

confidence: 99%

Risk factors of postoperative ileus following laparoscopic radical cystectomy and developing a points-based risk assessment scale

Xue¹,

Wang²,

Ji³

et al. 2021

Transl Androl Urol

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Background: Postoperative ileus (POI) is one of the most common complications after laparoscopic radical cystectomy (LRC). Albeit its high incidence, its risk factors are obscure, and few studies have attempted to explore them. Meanwhile, risk-assessing tools for predicting its happening are lacking. Methods: Clinical data of 197 patients who underwent LRC between March 2014 and October 2019 were retrospectively collected. All cases of POI were identified and double-checked. Data pertaining to the following categories were extracted as well: patients' general characteristics, preoperative laboratory tests results and preparations, intraoperative and postoperative general items, pathological results. The correlation between candidate risk factors and ileus was analyzed by multivariable binary logistic regression. Clinical and pathophysiological explanations for those results were explored. Finally, a points-based prediction model was developed and validated for predicting the happening of POI.Results: A total of 63 out of 197 patients (31.98%) suffered from POI. Multivariate logistic regression analysis showed chronic constipation, increased dosage of laxative, elevated preoperative serum creatinine level, delayed postoperative ambulation, intestine-related urine derivations were statistically significant for developing POI (P<0.05). No significant differences were found between POI and age, gender, body mass index (BMI), antibiotics, hypertension, diabetes, smoking, hard-drinking, preoperative hemoglobin level, preoperative albumin level, history of previous abdominal surgery, surgery time, intraoperative blood loss, blood transfusion, tumor size, lymph nodes yields, TNM staging and intensive care unit hospitalization.An external cohort had been used for testing the validation of the assessment scale, and the results were promising.Conclusions: Early recognition is of great importance in protecting vulnerable patients from developing POI, knowing the above-mentioned risk factors and using the assessment scale should help to screen them better. Cases from diverse backgrounds might contribute to a more accurate and complete scale.

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Section: Other Risk Factors For Developing Poi and What Could We Domentioning

confidence: 99%

Risk factors of postoperative ileus following laparoscopic radical cystectomy and developing a points-based risk assessment scale

Xue¹,

Wang²,

Ji³

et al. 2021

Transl Androl Urol

View full text Add to dashboard Cite

show abstract

“…More aggressive conservative treatment such as administration of neostigmine should be considered early in the nonoperative management. NG tube should be routinely considered, and if patients are not improving over 48-72 hours, further aggressive decompression should be considered either using a rectal tube, or colonoscopy per general surgery recommendations (10,13).…”

Section: A C U T E C O L O N I C P S E U D O -O B S T R U C T I O N ( a C P O ) I Smentioning

confidence: 99%

Perforated ileus after L5-S1 anterior lumbar interbody fusion: a case report presentation

2019

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Acute colonic pseudo-obstruction (ACPO) as a result of anterior lumbar spinal surgery can result in colonic perforation. ACPO is often treated successfully with conservative measures, reserving surgical intervention for severe cases. The most severe cases can result in colonic perforation with a concomitant high mortality rate. Herein we outline a case of a 72-year-old male with multiple medical comorbidities and history of intermittent constipation who underwent anterior lumbar interbody fusion (ALIF) of L5-S1. The patient's multiple medical comorbidities placed him at risk for ACPO. His postoperative course was complicated by an ileus. The patient initially underwent conservative management that failed, resulting in colonic perforation. He underwent urgent exploratory laparotomy and repair of colonic perforation by the general surgery service. The patient had spontaneous return of bowel function on postoperative day 5, and at 6 months, he was doing well. The main purpose of this case report is to present a unique case of colonic perforation after ALIF. Understanding patient risk factors can help in early identification and treatment of potentially life-threatening complications. Surgeons should discuss the possibility of this complication with the patient during surgical counseling for anterior lumbar surgery.

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“…Interestingly, goldfish neutrophils are the main source of the proinflammatory eicosanoid LTB 4 during the acute inflammatory phase, as well as of the proresolving eicosanoid LXA 4 during the proresolving phase of the inflammatory process. In mammals, neutrophil-derived LTB 4 is involved in the initial stages of neutrophil recruitment from blood to inflamed tissues [5]. However, the main eicosanoids produced in vitro by human neutrophils after activation by a variety of inflammatory stimuli are proinflammatory TXB 2 , the inactive metabolite of TXA 2 , and PGE 2 [6].…”

Section: Disclosuresmentioning

confidence: 99%

“…As in mice, uncomplicated ileus in humans is generally self limiting, with bowel motility returning in 3-5 d. As such, POI is considered by some to be a normal physiologic response and should be allowed to run its course. Contrary to this premise are observations that induction of ileus is not limited to direct bowel manipulation [5]. Circulating mediators arising from injured tissue following major orthopedic surgery or physical trauma readily traffic to the gastrointestinal tract, where they can induce the inflammatory events that cause bowel stasis.…”

mentioning

confidence: 99%