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 patients with ileus is usually remarkable for [[abdominal distension]], [[abdominal tenderness]], and [[Decreased bowel sounds|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== | ||
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 patients with ileus is usually remarkable for [[abdominal distension]], [[abdominal tenderness]], and [[Decreased bowel sounds|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> | ||
===Appearance of the Patient=== | ===Appearance of the Patient=== | ||
Patients with ileus usually appear fatigued. | Patients with ileus usually appear [[Fatigue (physical)|fatigued]]. | ||
===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]] | ||
===Abdomen=== | ===Abdomen=== | ||
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*[[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]] | ||
*Absent succussion splash | *Absent succussion splash | ||
*Tympanic on percussion | *Tympanic on [[percussion]] | ||
*Peritoneal signs suggests intestinal perforation such as: | *Peritoneal signs suggests intestinal perforation such as: | ||
**Rigidity | **Rigidity | ||
**Guarding | **[[Guarding]] | ||
**Rebound tenderness | **[[Rebound tenderness]] | ||
==References== | ==References== |
Revision as of 16:22, 5 February 2018
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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.[1][2][3][4][5]
Appearance of the Patient
Patients with ileus usually appear fatigued.
Vital Signs
- Tachycardia with regular pulse
- Low blood pressure with normal pulse pressure (uncommon)
- Orthostatic hypotension
Abdomen
Abdominal examination of patients with ileus includes:
- Abdominal distention
- Abdominal tenderness (severe cases)
- Hypoactive or absent bowel sounds
- Absent succussion splash
- Tympanic on percussion
- Peritoneal signs suggests intestinal perforation such as:
- Rigidity
- Guarding
- Rebound tenderness
References
- ↑ 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.