Case history
Case history
A 52-year-old man undergoes an elective sigmoid resection with primary colorectal anastomosis for chronic diverticulitis. The operative course is routine. Postoperatively, he starts on a clear-liquid diet and receives morphine via patient-controlled analgesia pump. On the second postoperative day, he has a distended abdomen, is nauseated, and has not passed flatus. He vomits repeatedly and requires nasogastric decompression. CT-scan shows uniform small bowel distention and no evidence of a transition zone between dilated and collapsed bowel (a key indicator of obstruction).
Other presentations
Ileus may also occur with acute systemic illness, such as myocardial infarction, metabolic derangements, sepsis, and gastrointestinal diseases.
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