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What is Postoperative ileus is most commonly seen in: and explain in detail?
Ans. a. Colon (Ref: Sabiston 19/e p1244; Schwartz 9/e p992-993; Bailey 26th/1197-1198, 25th/1261-1262: Shackelford 7/e p592-593)Post-operative ileus is most commonly seen in colon.Post-operative IleusFollowing most abdominal operations or injuries, the motility of the GI tract is transiently impaired.Proposed mechanisms responsible for this dysmotility are surgical stress-induced sympathetic reflexes, inflammatory response mediator release, and anesthetic/analgesic effectsQ; each of which can inhibit intestinal motility.Return of normal motility: Small intestineQ (within 24 hours) >Gastric (48 hours)Q > Colonic (3-5 days)Q.Post-operative ileus is most pronounced in colonQCharacteristic sequence of return of normal motility: Small intestinal motility returning to normal within the first 24 hours, gastric motility within 48 hours and colonic motility returning to normal 3 to 5 daysQ.Because small bowel motility is returned before colonic and gastric motility, listening for bowel sounds is not a reliable indicator that ileus has fully resolvedQ.