Ileus physical examination
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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
- Tachycardia with regular pulse
- Low blood pressure with normal pulse pressure (uncommon)
- Orthostatic hypotension
- Patients who developed complications such as intestinal perforation or peritonitis are possibly feverish.
Skin
- Skin examination of patients with ileus is usually normal.
HEENT
- HEENT examination of patients with ileus is usually normal.
Neck
- Neck examination of patients with ileus is usually normal.
Lungs
- Pulmonary examination of patients with ileus is usually normal.
Heart
- Cardiovascular examination of patients with ileus is usually normal.
Abdomen
Abdominal examination of patients with ileus includes:[8][9][10][11][12][1][13]
- Abdominal distention
- Abdominal tenderness (severe cases)
- Hypoactive or absent bowel sounds (characteristic finding)
- Absent succussion splash
- Tympanic on percussion
- Peritoneal signs suggests intestinal perforation such as:
- Rigidity
- Guarding
- Rebound tenderness
Back
- Back examination of patients with ileus is usually normal.
Genitourinary
- Genitourinary examination of patients with ileus is usually normal.
Neuromuscular
- Neuromuscular examination of patients with ileus is usually normal.
Extremities
- Extremities examination of patients with ileus is usually normal.
References
- ↑ 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.
- ↑ 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.
- ↑ 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.
- ↑ 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.
- ↑ 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.
- ↑ 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.
- ↑ 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.
- ↑ "Ileus and Bowel Obstruction - Holland-Frei Cancer Medicine - NCBI Bookshelf".
- ↑ 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.
- ↑ Stewart D, Waxman K (2007). "Management of postoperative ileus". Am J Ther. 14 (6): 561–6. doi:10.1097/MJT.0b013e31804bdf54. PMID 18090881.
- ↑ 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.
- ↑ 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.
- ↑ 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.