Peer-reviewed veterinary case report
Postoperative ileus: pathogenesis and treatment.
- Journal:
- The Veterinary clinics of North America. Equine practice
- Year:
- 2009
- Authors:
- Doherty, Thomas J
- Affiliation:
- Department of Large Animal Clinical Sciences · United States
Plain-English summary
After surgery on the intestines, some pets can develop a condition called postoperative ileus, where their intestines don't move food along as they should. This happens because the surgery can trigger certain immune responses that slow down intestinal activity. Other factors, like too much fluid given during surgery or long cuts on the abdomen, can make this problem worse. While medications to stimulate the intestines haven't been very effective, there are ways to help reduce the severity of this condition, such as using pain relief before surgery, making smaller cuts, and carefully managing fluids. Overall, the focus is on preventing the issue rather than just treating it after it occurs.
Abstract
Surgical manipulation of the intestines activates intestinal macrophages that release cytokines and nitric oxide, which results in inhibition of intestinal motility. Subsequent infiltration of circulating leukocytes into the intestinal wall contributes to cytokine and nitric oxide release and exacerbates ileus. Other factors contributing to ileus are endotoxemia; edema of the intestine wall subsequent to excessive fluid therapy; hypocalcemia; and long abdominal incisions. Because treatment of ileus with prokinetic drugs has not proven to be very effective, efforts should be directed at reducing its severity. Strategies which reduce the severity of ileus include pretreatment with a nonsteroidal anti-inflammatory drug, minimizing the length of the abdominal incision, reducing intestinal manipulation, intraoperative lidocaine infusion, correction of hypocalcemia, limiting the volume of intravenous fluids to prevent intestinal edema, and administration of alpha(2) antagonists.
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Search related cases →Original publication: https://pubmed.ncbi.nlm.nih.gov/19580945/