In ileus (thesaurus synonyms: Axial rotation of the sigmoid flexure; Axial rotation of the intestine; Axial rotation of the colon; Axial rotation of the mesentery; Axial rotation of the omentum; Axial rotation of the cecum; Adhesive ileus; Adynamic intestinal obstruction; Adynamic intestinal obstruction; Atonic ileus; Peritoneal adhesion with ileus; Bridenileus; Intestinal kink; Intestinal axis rotation; Intestinal impaction; Intestinal impaction due to gallstone; Intestinal impaction; Intestinal impaction; Intestinal gangrene with intestinal obstruction; Intestinal ileus; Intestinal intussusception; Intestinal kink; Intestinal compression; Intestinal constriction; Intestinal contracture; Intestinal paralysis; Intestinal obstruction; Intestinal obstruction by gallstone; Intestinal obstruction by volvulus; Intestinal obturation; Intestinal occlusion; Intestinal paralysis; Intestinal paresis; Intestinal stone; Intestinal stenosis; Intestinal strangulation; Intestinal stricture; Intestinal torsion; Intestinal torsion; Intestinal entanglement; Intestinal obstruction; Intestinal obstruction by brides; Intestinal obstruction by gallstone; Intestinal obstruction by volvulus; Intestinal obstruction with adhesion; Intestinal adhesion with occlusion; Intestinal volvulus; Large bowel obstruction; Large bowel ileus; Large bowel stenosis; Large bowel stricture; Large bowel obstruction; Duodenal torsion; Small bowel bridenileus; Small bowel intussusception; Small bowel paralysis; Small bowel stenosis; Small bowel stricture; Small bowel obstruction; Small bowel volvulus; Entrapped fecal stone; Entrapment of enterolith; Entrapment of feces; Enterolith; Enterolithiasis; Enterostenosis; Fecal entrapment; Gallstone ileus; Gangrene of intestine with bowel obstruction; Gangrene of the mesentery with intestinal obstruction; Gastrointestinal obstruction; Gastrointestinal obstruction; Fermentation ileus; Ileum kink; Ileum obstruction; Ileum stenosis; Ileum stricture; Ileum obstruction; Ileum volvulus; Ileus; Ileus of intestine; Ileus of colon; Ileus due to peritoneal adhesion; Ileus due to peritoneal adhesion; Ileus obturatorius; Intestinal adhesion with ileus; Intestinal intussusception; Intestinal kink; Intestinal occlusion; Intestinal paralysis a. n.k. ; Intestinal paresis; Intestinal stenosis; Intestinal strangulation; Intestinal stricture; Intestinal torsion; Intestinal kinking; Intestinal obstruction; Intussusception; Intussusception of the intestine; Intussusception of the intestine; Intussusception of the colon; Intussusception of the rectum; Invagination; Intestinal invagination; Rectal invagination; Invagination ileus; Jejunal obstruction; Jejunal stenosis; Jejunal stricture; Jejunal obstruction; Colonic impaction; Colonic invagination; Colonic obstruction; Colonic occlusion; Colonic paralysis a. n.k. ; Colonic paresis; Colonic stenosis; Colonic strangulation; Colonic stricture; Colonic torsion; Colonic occlusion; Coprolith; Coprolithiasis; Coprostasis; Coeliac impaction; Fecal impaction; Fecal obstruction; Fecal calculus; Fecal occlusion; Mechanical intestinal obstruction; Mechanical intestinal obstruction; Mechanical large bowel obstruction; Mechanical small bowel obstruction; Mechanical small bowel obstruction; Mechanical ileal obstruction; Mechanical ileus a. n.k. ; Mechanical intestinal obstruction; Mechanical jejunal obstruction; Mechanical colonic obstruction; Mechanical cecal obstruction; Neurogenic intestinal obstruction; Neurogenic ileus; Obstruction of the junction of the sigmoid colon with the rectum; Obstructive ileus a. n.k. ; Obstructive tissue cord of the intestine; Obstructive tissue cord of the peritoneum; Obturation ileus; Ogilvie’s syndrome; Paralytic intestinal obstruction; Paralytic large bowel obstruction; Paralytic small bowel ileus; Paralytic small bowel obstruction; Paralytic ileum obstruction; Paralytic ileus; Paralytic intestinal obstruction; Paralytic jejunal obstruction; Paralytic colonic obstruction; Paralytic cecal obstruction; Paroxysmal intestinal obstruction; Peritoneal adhesion with intestinal obstruction; Peritoneal adhesion with ileus; Postinfectious intestinal adhesion with ileus; Postinfectious intestinal obstruction; Preileus; Pseudoobstructive ileus; Rectosigmoid obstruction; Rectosigmoid stricture; Rectal obstruction; Sigmoid stenosis; Sigmoid volvulus; Sigmoid obstruction; Strangileus; Strangulation of the mesentery; Strangulation of the omentum; Strangulation ileus; Flexura coli sigmoidea stricture; Sigmoid flexure stricture; Subileus; Torsion of mesentery; Torsion of omentum; Torsion ileus; Volvulus; Volvulus of intestine; Volvulus of colon; Cecal obstruction; Cecal stricture; Cecal obstruction; ICD-10-GM K56. -: Paralytic ileus and intestinal obstruction without hernia) is an intestinal obstruction. This represents a dangerous interruption of the intestinal passage. In a large proportion of cases (75%), ileus occurs after abdominal surgery.The number of cases is lower for laparoscopic procedures (laparoscopy; “keyhole surgery”) than for laparotomies (abdominal incision; surgical opening of the abdominal cavity). Appendectomy (surgical removal of the inflamed appendix) is responsible for ileus in 40% of cases. Ileus can be classified according to different criteria:
According to etiology (cause):
- Mechanical ileus – obstruction of the intestinal lumen due to an obstruction from the outside (extraluminal) or inside (intraluminal), as well as due to a posterior obstruction, which is located in the organ wall (intramural).
- functional ileus
- Spastic ileus – e.g., in lead poisoning; very rare.
- Paralytic ileus (synonym: atonic ileus) – smooth muscle paralysis (arrest of peristalsis (intestinal movement)); common.
In the course of a mechanical ileus occurs paralytic ileus. According to the etiology, one can distinguish other special forms:
- Bridenileus – intestinal obstruction due to adhesion strands in the abdominal cavity.
- Gallstone ileus – intestinal obstruction caused by a gallstone in the intestinal lumen.
- Invagination – invagination of one portion of the intestine into another portion; occurs preferentially in children
- Meconium ileus – intestinal obstruction of a newborn due to the meconium (“infantile saliva“).
- Volvulus – intestinal obstruction due to twisting of the intestine around its axis.
Furthermore, ileus can be classified according to the localization:
- Colonic ileus – in 50% of cases caused by carcinoma (cancer).
- Small intestinal ileus – in 50% of cases caused by bridenileus (intestinal obstruction due to adhesion strands in the abdominal cavity).
70-80% of all ilei are found in the small intestine and 20-30% in the colon (large intestine). One speaks of a subileus when the intestinal lumen is only narrowed, but not completely displaced. Frequency peak: intussusception occurs most frequently in infants in the second half of life. Ileus often occurs as a complication of advanced tumor disease (cancer). In patients with advanced ovarian cancer, the prevalence of ileus ranges from 5 to 42%, and in patients with colorectal cancer, the prevalence ranges from 4 to 24%. Course and prognosis: The course of an ileus depends on the causes and the location of the obstruction. As a life-threatening condition, ileus generally requires immediate hospitalization and often surgical intervention. Otherwise, parts of the intestine may die or intestinal contents may perforate (break through) the intestinal wall, among other things. The sooner treatment is given, the more favorable the prognosis. For every hour that passes without adequate therapy, the risk of a lethal (fatal) course increases by about 1%. In inoperable ileus occurring in association with advanced tumor disease, survival is a few weeks to a few months (if tumor-specific therapy is not available).The perioperative lethality (mortality relative to the total number of people with the disease) of an emergency laparotomy due to manifest ileus is 5-15%.
