Ileus physical examination: Difference between revisions

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==Overview==
==Overview==
Physical examination of patients with ileus is usually remarkable for abdominal distension, abdominal tenderness, and minimal or absent bowel sounds. Patients with prolonged ileus may progress to develop peritoneal signs such as rigidity, guarding and rebound tenderness.
[[Physical examination]] of [[patient|patients]] with [[ileus]] is usually remarkable for [[abdominal distension]], [[abdomen|abdominal]] tenderness, and [[Decreased bowel sounds|minimal]] or [[absent bowel sounds]]. [[patient|Patients]] with prolonged [[ileus]] may progress to develop [[peritoneal]] signs such as rigidity, [[guarding]] and [[rebound tenderness]].


==Physical Examination==
==Physical Examination==
Physical examination of patients with ileus is usually remarkable for abdominal distension, abdominal tenderness, and minimal or absent bowel sounds.<ref name="pmid22866434">{{cite journal |vauthors=Massey RL |title=Return of bowel sounds indicating an end of postoperative ileus: is it time to cease this long-standing nursing tradition? |journal=Medsurg Nurs |volume=21 |issue=3 |pages=146–50 |year=2012 |pmid=22866434 |doi= |url=}}</ref><ref name="pmid24776861">{{cite journal |vauthors=Felder S, Margel D, Murrell Z, Fleshner P |title=Usefulness of bowel sound auscultation: a prospective evaluation |journal=J Surg Educ |volume=71 |issue=5 |pages=768–73 |year=2014 |pmid=24776861 |doi=10.1016/j.jsurg.2014.02.003 |url=}}</ref><ref name="pmid28439845">{{cite journal |vauthors=Rami Reddy SR, Cappell MS |title=A Systematic Review of the Clinical Presentation, Diagnosis, and Treatment of Small Bowel Obstruction |journal=Curr Gastroenterol Rep |volume=19 |issue=6 |pages=28 |year=2017 |pmid=28439845 |doi=10.1007/s11894-017-0566-9 |url=}}</ref><ref name="pmid6849489">{{cite journal |vauthors=Sarr MG, Bulkley GB, Zuidema GD |title=Preoperative recognition of intestinal strangulation obstruction. Prospective evaluation of diagnostic capability |journal=Am. J. Surg. |volume=145 |issue=1 |pages=176–82 |year=1983 |pmid=6849489 |doi= |url=}}</ref><ref name="pmid28818187">{{cite journal |vauthors=Vilz TO, Stoffels B, Strassburg C, Schild HH, Kalff JC |title=Ileus in Adults |journal=Dtsch Arztebl Int |volume=114 |issue=29-30 |pages=508–518 |year=2017 |pmid=28818187 |pmc=5569564 |doi=10.3238/arztebl.2017.0508 |url=}}</ref>
[[Physical examination]] of [[patient|patients]] with [[ileus]] is usually remarkable for [[abdominal distension]], [[abdominal tenderness]], and [[Decreased bowel sounds|minimal]] or [[absent bowel sounds]] (characteristic finding).<ref name="pmid22866434">{{cite journal |vauthors=Massey RL |title=Return of bowel sounds indicating an end of postoperative ileus: is it time to cease this long-standing nursing tradition? |journal=Medsurg Nurs |volume=21 |issue=3 |pages=146–50 |year=2012 |pmid=22866434 |doi= |url=}}</ref><ref name="pmid24776861">{{cite journal |vauthors=Felder S, Margel D, Murrell Z, Fleshner P |title=Usefulness of bowel sound auscultation: a prospective evaluation |journal=J Surg Educ |volume=71 |issue=5 |pages=768–73 |year=2014 |pmid=24776861 |doi=10.1016/j.jsurg.2014.02.003 |url=}}</ref><ref name="pmid28439845">{{cite journal |vauthors=Rami Reddy SR, Cappell MS |title=A Systematic Review of the Clinical Presentation, Diagnosis, and Treatment of Small Bowel Obstruction |journal=Curr Gastroenterol Rep |volume=19 |issue=6 |pages=28 |year=2017 |pmid=28439845 |doi=10.1007/s11894-017-0566-9 |url=}}</ref><ref name="pmid6849489">{{cite journal |vauthors=Sarr MG, Bulkley GB, Zuidema GD |title=Preoperative recognition of intestinal strangulation obstruction. Prospective evaluation of diagnostic capability |journal=Am. J. Surg. |volume=145 |issue=1 |pages=176–82 |year=1983 |pmid=6849489 |doi= |url=}}</ref><ref name="pmid28818187">{{cite journal |vauthors=Vilz TO, Stoffels B, Strassburg C, Schild HH, Kalff JC |title=Ileus in Adults |journal=Dtsch Arztebl Int |volume=114 |issue=29-30 |pages=508–518 |year=2017 |pmid=28818187 |pmc=5569564 |doi=10.3238/arztebl.2017.0508 |url=}}</ref><ref name="pmid26843914">{{cite journal |vauthors=Nuño-Guzmán CM, Marín-Contreras ME, Figueroa-Sánchez M, Corona JL |title=Gallstone ileus, clinical presentation, diagnostic and treatment approach |journal=World J Gastrointest Surg |volume=8 |issue=1 |pages=65–76 |date=January 2016 |pmid=26843914 |pmc=4724589 |doi=10.4240/wjgs.v8.i1.65 |url=}}</ref><ref name="pmid15269690">{{cite journal |vauthors=Grassi R, Di Mizio R, Pinto A, Romano L, Rotondo A |title=Serial plain abdominal film findings in the assessment of acute abdomen: spastic ileus, hypotonic ileus, mechanical ileus and paralytic ileus |journal=Radiol Med |volume=108 |issue=1-2 |pages=56–70 |date=2004 |pmid=15269690 |doi= |url=}}</ref>
===Appearance of the Patient===
===Appearance of the patient===
Patients with ileus usually appear fatigued.  
*[[patient|Patients]] with [[ileus]] usually appear [[Fatigue (physical)|fatigued]] and in discomfort.  


===Vital Signs===
===Vital signs===
*[[Tachycardia]] with regular pulse
*[[Tachycardia]] with regular [[pulse]]
*Low blood pressure with normal pulse pressure (uncommon)  
*[[Low blood pressure]] with normal [[pulse pressure]] (uncommon)  
*Orthostatic hypotension  
*[[Orthostatic hypotension]]
*[[patient|Patients]] who developed [[Complication (medicine)|complications]] such as [[intestine|intestinal]] [[Gastrointestinal perforation|perforation]] or [[peritonitis]] are possibly [[fever|feverish]].
 
===Skin===
* [[Skin]] [[Physical examination|examination]] of [[patient|patients]] with [[ileus]] is usually normal.
 
===HEENT===
* HEENT [[Physical examination|examination]] of [[patient|patients]] with [[ileus]] is usually normal.
 
===Neck===
* [[Neck]] [[Physical examination|examination]] of [[patient|patients]] with [[ileus]] is usually normal.
 
===Lungs===
* [[Lung|Pulmonary]] [[Physical examination|examination]] of [[patient|patients]] with [[ileus]] is usually normal.
 
===Heart===
* [[Circulatory system|Cardiovascular]] [[Physical examination|examination]] of [[patient|patients]] with [[ileus]] is usually normal.


===Abdomen===
===Abdomen===
Abdominal examination of patients with ileus includes:
[[abdome|Abdominal]] [[Physical examination|examination]] of [[patient|patients]] with [[ileus]] includes:<ref name="urlIleus and Bowel Obstruction - Holland-Frei Cancer Medicine - NCBI Bookshelf">{{cite web |url=https://www.ncbi.nlm.nih.gov/books/NBK13786/ |title=Ileus and Bowel Obstruction - Holland-Frei Cancer Medicine - NCBI Bookshelf |format= |work= |accessdate=}}</ref><ref name="pmid20119556">{{cite journal |vauthors=Carroll J, Alavi K |title=Pathogenesis and management of postoperative ileus |journal=Clin Colon Rectal Surg |volume=22 |issue=1 |pages=47–50 |date=February 2009 |pmid=20119556 |pmc=2780226 |doi=10.1055/s-0029-1202886 |url=}}</ref><ref name="pmid18090881">{{cite journal |vauthors=Stewart D, Waxman K |title=Management of postoperative ileus |journal=Am J Ther |volume=14 |issue=6 |pages=561–6 |date=2007 |pmid=18090881 |doi=10.1097/MJT.0b013e31804bdf54 |url=}}</ref><ref name="pmid23055768">{{cite journal |vauthors=Macaluso CR, McNamara RM |title=Evaluation and management of acute abdominal pain in the emergency department |journal=Int J Gen Med |volume=5 |issue= |pages=789–97 |date=2012 |pmid=23055768 |pmc=3468117 |doi=10.2147/IJGM.S25936 |url=}}</ref><ref name="pmid23902744">{{cite journal |vauthors=Coppolino F, Gatta G, Di Grezia G, Reginelli A, Iacobellis F, Vallone G, Giganti M, Genovese E |title=Gastrointestinal perforation: ultrasonographic diagnosis |journal=Crit Ultrasound J |volume=5 Suppl 1 |issue= |pages=S4 |date=July 2013 |pmid=23902744 |pmc=3711723 |doi=10.1186/2036-7902-5-S1-S4 |url=}}</ref><ref name="pmid22866434">{{cite journal |vauthors=Massey RL |title=Return of bowel sounds indicating an end of postoperative ileus: is it time to cease this long-standing nursing tradition? |journal=Medsurg Nurs |volume=21 |issue=3 |pages=146–50 |date=2012 |pmid=22866434 |doi= |url=}}</ref><ref name="pmid19966732">{{cite journal |vauthors=Baid H |title=A critical review of auscultating bowel sounds |journal=Br J Nurs |volume=18 |issue=18 |pages=1125–9 |date=2009 |pmid=19966732 |doi=10.12968/bjon.2009.18.18.44555 |url=}}</ref>
*[[Abdominal distention]]  
*[[Abdominal distention]]  
*[[Abdominal tenderness]] (severe cases)  
*[[Abdominal tenderness]] (severe cases)  
*Hypoactive or absent bowel sounds  
*[[Decreased bowel sounds|Hypoactive]] or [[absent bowel sounds]] (characteristic finding)
*Absent succussion splash
*Absent succussion splash
*Tympanic on percussion
*Tympanic on [[percussion]]
*Peritoneal signs suggests intestinal perforation such as:
*[[Peritoneum|Peritoneal]] signs suggests [[intestinal perforation]] such as:
**Rigidity
**Rigidity
**Guarding
**[[Guarding]]
**Rebound tenderness
**[[Rebound tenderness]]
 
===Back===
* [[Human back|Back]] [[Physical examination|examination]] of [[patient|patients]] with [[ileus]] is usually normal.
 
===Genitourinary===
* Genitourinary [[Physical examination|examination]] of [[patient|patients]] with [[ileus]] is usually normal.
 
===Neuromuscular===
* [[Neuromuscular junction|Neuromuscular]] [[Physical examination|examination]] of [[patient|patients]] with [[ileus]] is usually normal.
 
===Extremities===
* [[Limb (anatomy)|Extremities]] [[Physical examination|examination]] of [[patient|patients]] with [[ileus]] is usually normal.


==References==
==References==
{{Reflist|2}}
{{Reflist|2}}


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Latest revision as of 18:55, 11 October 2020

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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

Physical examination of patients with ileus is usually remarkable for abdominal distension, abdominal tenderness, and minimal or absent bowel sounds. Patients with prolonged ileus may progress to develop peritoneal signs such as rigidity, guarding and rebound tenderness.

Physical Examination

Physical examination of patients with ileus is usually remarkable for abdominal distension, abdominal tenderness, and minimal or absent bowel sounds (characteristic finding).[1][2][3][4][5][6][7]

Appearance of the patient

Vital signs

Skin

HEENT

Neck

Lungs

Heart

Abdomen

Abdominal examination of patients with ileus includes:[8][9][10][11][12][1][13]

Back

Genitourinary

Neuromuscular

Extremities

References

  1. ↑ 1.0 1.1 Massey RL (2012). "Return of bowel sounds indicating an end of postoperative ileus: is it time to cease this long-standing nursing tradition?". Medsurg Nurs. 21 (3): 146–50. PMID 22866434.
  2. ↑ Felder S, Margel D, Murrell Z, Fleshner P (2014). "Usefulness of bowel sound auscultation: a prospective evaluation". J Surg Educ. 71 (5): 768–73. doi:10.1016/j.jsurg.2014.02.003. PMID 24776861.
  3. ↑ Rami Reddy SR, Cappell MS (2017). "A Systematic Review of the Clinical Presentation, Diagnosis, and Treatment of Small Bowel Obstruction". Curr Gastroenterol Rep. 19 (6): 28. doi:10.1007/s11894-017-0566-9. PMID 28439845.
  4. ↑ Sarr MG, Bulkley GB, Zuidema GD (1983). "Preoperative recognition of intestinal strangulation obstruction. Prospective evaluation of diagnostic capability". Am. J. Surg. 145 (1): 176–82. PMID 6849489.
  5. ↑ Vilz TO, Stoffels B, Strassburg C, Schild HH, Kalff JC (2017). "Ileus in Adults". Dtsch Arztebl Int. 114 (29–30): 508–518. doi:10.3238/arztebl.2017.0508. PMC 5569564. PMID 28818187.
  6. ↑ Nuño-Guzmán CM, Marín-Contreras ME, Figueroa-Sánchez M, Corona JL (January 2016). "Gallstone ileus, clinical presentation, diagnostic and treatment approach". World J Gastrointest Surg. 8 (1): 65–76. doi:10.4240/wjgs.v8.i1.65. PMC 4724589. PMID 26843914.
  7. ↑ Grassi R, Di Mizio R, Pinto A, Romano L, Rotondo A (2004). "Serial plain abdominal film findings in the assessment of acute abdomen: spastic ileus, hypotonic ileus, mechanical ileus and paralytic ileus". Radiol Med. 108 (1–2): 56–70. PMID 15269690.
  8. ↑ "Ileus and Bowel Obstruction - Holland-Frei Cancer Medicine - NCBI Bookshelf".
  9. ↑ Carroll J, Alavi K (February 2009). "Pathogenesis and management of postoperative ileus". Clin Colon Rectal Surg. 22 (1): 47–50. doi:10.1055/s-0029-1202886. PMC 2780226. PMID 20119556.
  10. ↑ Stewart D, Waxman K (2007). "Management of postoperative ileus". Am J Ther. 14 (6): 561–6. doi:10.1097/MJT.0b013e31804bdf54. PMID 18090881.
  11. ↑ Macaluso CR, McNamara RM (2012). "Evaluation and management of acute abdominal pain in the emergency department". Int J Gen Med. 5: 789–97. doi:10.2147/IJGM.S25936. PMC 3468117. PMID 23055768.
  12. ↑ Coppolino F, Gatta G, Di Grezia G, Reginelli A, Iacobellis F, Vallone G, Giganti M, Genovese E (July 2013). "Gastrointestinal perforation: ultrasonographic diagnosis". Crit Ultrasound J. 5 Suppl 1: S4. doi:10.1186/2036-7902-5-S1-S4. PMC 3711723. PMID 23902744.
  13. ↑ Baid H (2009). "A critical review of auscultating bowel sounds". Br J Nurs. 18 (18): 1125–9. doi:10.12968/bjon.2009.18.18.44555. PMID 19966732.

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