prolonged postop ileus

Q: In general, how many days after surgery, if no bowel motility returns are considered as 'prolonged postoperative ileus'?


Answer: 4

'Postoperative ileus' is confounded by so many factors in an individualized patient that it is hard to put this period in black and white. Per an international consensus panel fewer than four days after surgery for bowel movement, passing of flatus or stool or tolerance of diet is considered "normal" or "obligatory" postoperative ileus. The panel also defined "prolonged" postoperative ileus as the occurrence of two or more of the following by postoperative day 4 or after:

• Nausea or vomiting
• Inability to tolerate an oral diet over the preceding 24 hours 
• Absence of flatus over the last 24 hours 
• Abdominal distention 
• Radiologic confirmation of ileus  

#surgical-critical-care


Reference:

Vather R, Trivedi S, Bissett I. Defining postoperative ileus: results of a systematic review and global survey. J Gastrointest Surg 2013; 17:962.