postoperative ileus

Q: All of the following may lead to prolonged postoperative ileus except?

A) Hyperkalemia 
B) Hypomagnesemia
C) Uremia 
D) Gallbladder dysfunction
E) Pancreatitis 



Answer: A

Laboratory or radiological workup should be initiated or monitored daily if postoperative ileus lasts more than 48 to 72 hours despite all appropriate measures. Various factors may lead to prolonged postoperative ileus in surgical ICU including hypokalemia, hypomagnesemia, anemia, infection (leucocytosis), ischemia (lactate elevation), renal dysfunction (uremia), gallbladder dysfunction (liver function test or ultrasound of abdomen), and pancreatitis (amylase & lipase elevation).

#surgicalcriticalcare
#gastroenterology


References:

1. Person B, Wexner SD. The management of postoperative ileus. Curr Probl Surg. 2006 Jan. 43(1):6-65. 

2. Mattei P, Rombeau JL. Review of the pathophysiology and management of postoperative ileus. World J Surg. 2006 Aug. 30(8):1382-91 

3. Behm B, Stollman N. Postoperative ileus: etiologies and interventions. Clin Gastroenterol Hepatol. 2003 Mar. 1(2):71-80. 

4. Carter S. The surgical team and outcomes management: focus on postoperative ileus. J Perianesth Nurs. 2006 Apr. 21(2A Suppl):S2-6.