Ileus causes

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Akshun Kalia M.B.B.S.[2]

Overview

Common causes of ileus include surgery (major abdominal & non-abdominal surgeries), metabolic and electrolyte disturbances (such as hyponatremia, hypokalemia, hypocalcemia and hypomagnesemia), Endocrine disorders (such as diabetes, hypoparathyroidism, hypothyroidism, and adrenal insufficiency), systemic disorders (such as myocardial infarction, pneumonia, renal failure), trauma, sepsis, and drugs (such as opiates, anticholinergic agents, autonomic blockers, tricyclic antidepressants and general anesthesia).

Causes

Common Causes

The common causes of ileus include:^[1]^[2]^[3]^[4]^[5]

Causes by Organ System

Cardiovascular	Heart Attack
Chemical/Poisoning	Lead poisoning, Thallium
Dental	No underlying causes
Dermatologic	No underlying causes
Drug Side Effect	Anticholinergic drugs, Acetaminophen, Oxycodone, Antihistamines, Benzatropine, Ixabepilone, Ioxilan,Lanthanum carbonate, Loperamide, meclofenamate,Meropenem, Morphine, Olanzapine, Opiates, Pramipexole, Vinblastine
Ear Nose Throat	No underlying causes
Endocrine	Diabetic coma, Diabetic ketoacidosis, Hyperparathyroidism
Environmental	No underlying causes
Gastroenterologic	Adenomatous polyps, Annular pancreas, Appendicitis, Atresia, Biliary calculus, Cholecystitis, Cholecystolithiasis, Colon Cancer, Complications of intra-abdominal surgery, Congenital megacolon, Crohn's Disease, Diverticular stricture, Diverticulitis, Gallstone ileus, Gastrointestinal bleeding, Hematoma of the bowel wall, Hemoperitoneum, Hernia, Incarcerated hernia, Intestinal ischaemia, Intrabdominal hematoma, Intussusception , Megacolon, Mesenteric infarction, Mesenteric ischemia, Multiple polyposis syndromes, Superior mesenteric artery occlusion, Ulcer perforation, Ulcerative colitis, Volvulus
Genetics	Hirschprung's disease, Imperforate anus, Malrotation, Meckel's Diverticulum
Hematologic	Lymphoma, Retroperitoneal hematoma
Iatrogenic	Abdominal surgery, Adhesions, Anastomotic leaks, Joint or spine surgery, Laparotomy, Postoperative, Surgery complication, Surgical anastomosis
Infectious Disease	Peritonitis , Abdominal infections, Abdominopelvic abscess, Ascariasis, Botulism, Infection, Intrabdominal abscess, intraperitoneal infection, Osteomyelitis of the Spinal cord, Pancreatitis, Perinephric abscess, Peritonitis, Pneumatosis intestinalis, Pneumonia, Psoas abscess, Sepsis, Severe generalized infections , Tuberculosis, Urosepsis
Musculoskeletal/Orthopedic	No underlying causes
Neurologic	Spinal cord inflammation, Spinal cord injury
Nutritional/Metabolic	Acute intermittent porphyria
Obstetric/	Endometriosis, Neonatal necrotizing enterocolitis, Pregnancy
Oncologic	Cancer, Peritoneal carcinomatosis, Sarcoma, lymphoma
Ophthalmologic	No underlying causes
Overdose/Toxicity	No underlying causes
Psychiatric	No underlying causes
Pulmonary	Mechanical ventilation
Renal/Electrolyte	Acid-base imbalance disturbance, Hypokalaemia, Hypomagnesemia, Kidney diseases, Pyelonephritis, Renal colic, Uremia
Rheumatology/Immunology/Allergy	Connective tissue disease, Henoch-Schönlein purpura, Scleroderma
Sexual	No underlying causes
Trauma	Injury or trauma to abdomen , Injury to the abdominal blood supply , Penetrating wounds
Urologic	No underlying causes
Miscellaneous	Apoplexy, Burns, Cysts, Disorders that affect muscle function, foreign bodies , Radiation induced stenosis

Causes in Alphabetical Order

Abdominal infections
Abdominal surgery
Abdominopelvic abscess
Acid-base imbalance
Acute pancreatitis
Acute intermittent porphyria
Adenomatous polyps
adhesions
Anastomotic leaks
Annular pancreas
Anticholinergic drugs
Antihistamines
Apoplexy
Appendicitis
Ascariasis
Atresia
Biliary calculus
Botulism
Burns
Cancer
Carcinomatosis
Cholecystitis
Cholecystolithiasis
Colon Cancer
Complications of intra-abdominal surgery
Congenital megacolon
Connective tissue disease
Crohn's Disease
Cysts
Diabetic coma
Diabetic ketoacidosis
Disorders that affect muscle function
Diverticular stricture
Diverticulitis
Endometriosis
foreign bodies

Causes based on type of obstruction

Earlier, the term ileus was used to describe temporary cessation of intestinal peristalsis. In the recent times, the term "ileus" has been modified to include temporary cessation of intestinal peristalsis in the absence of mechanical obstruction. However, in order to include all the causes, we are hereby including all the causes which may lead to cessation of intestinal peristalsis. The list as below:

Mechanical Obstruction

Non-Mechanical Obstruction

Pseudo-Obstruction

Aerophagia
Functional bowel disease

References

↑ Funder JA, Tolstrup R, Jepsen BN, Iversen LH (2017). "Postoperative paralytic ileus remains a problem following surgery for advanced pelvic cancers". J. Surg. Res. 218: 167–173. doi:10.1016/j.jss.2017.05.044. PMID 28985845.
↑ Aday U, Gündeş E, Değer KC, Çiyiltepe H, Kayıpmaz Ş, Duman M (2017). "A rare cause of ileus: late jejunal stricture following blunt abdominal trauma". Ulus Travma Acil Cerrahi Derg. 23 (1): 74–76. PMID 28261776.
↑ Stakenborg N, Gomez-Pinilla PJ, Boeckxstaens GE (2017). "Postoperative Ileus: Pathophysiology, Current Therapeutic Approaches". Handb Exp Pharmacol. 239: 39–57. doi:10.1007/164_2016_108. PMID 27999957.
↑ Boobés K, Rosa RM, Batlle D (2017). "Hypokalemia associated with acute colonic pseudo-obstruction in an ESRD patient". Clin. Nephrol. 87 (2017) (3): 152–156. doi:10.5414/CN109002. PMID 28025959.
↑ Guay J, Nishimori M, Kopp SL (2016). "Epidural Local Anesthetics Versus Opioid-Based Analgesic Regimens for Postoperative Gastrointestinal Paralysis, Vomiting, and Pain After Abdominal Surgery: A Cochrane Review". Anesth. Analg. 123 (6): 1591–1602. doi:10.1213/ANE.0000000000001628. PMID 27870743.

[pmid28985845-1] Funder JA, Tolstrup R, Jepsen BN, Iversen LH (2017). "Postoperative paralytic ileus remains a problem following surgery for advanced pelvic cancers". J. Surg. Res. 218: 167–173. doi:10.1016/j.jss.2017.05.044. PMID 28985845.

[pmid28261776-2] Aday U, Gündeş E, Değer KC, Çiyiltepe H, Kayıpmaz Ş, Duman M (2017). "A rare cause of ileus: late jejunal stricture following blunt abdominal trauma". Ulus Travma Acil Cerrahi Derg. 23 (1): 74–76. PMID 28261776.

[pmid27999957-3] Stakenborg N, Gomez-Pinilla PJ, Boeckxstaens GE (2017). "Postoperative Ileus: Pathophysiology, Current Therapeutic Approaches". Handb Exp Pharmacol. 239: 39–57. doi:10.1007/164_2016_108. PMID 27999957.

[pmid28025959-4] Boobés K, Rosa RM, Batlle D (2017). "Hypokalemia associated with acute colonic pseudo-obstruction in an ESRD patient". Clin. Nephrol. 87 (2017) (3): 152–156. doi:10.5414/CN109002. PMID 28025959.

[pmid27870743-5] Guay J, Nishimori M, Kopp SL (2016). "Epidural Local Anesthetics Versus Opioid-Based Analgesic Regimens for Postoperative Gastrointestinal Paralysis, Vomiting, and Pain After Abdominal Surgery: A Cochrane Review". Anesth. Analg. 123 (6): 1591–1602. doi:10.1213/ANE.0000000000001628. PMID 27870743.

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