Adynamic Ileus Definition, Symptoms, Causes, Treatment

Adynamic ileus is a disease in which peristaltic movement of small intestine and large intestine cease or stop. As the name "ileus" indicates the part of small intestine i.e. ileum. It occurs due to failure of nerve stimulation of small intestine. In Adynamic ileus bowel movement stops and food do not passes on to colon or rectum. It is described as paralysis of motion of small intestine. Usually adynamic ileus is asymptomatic and does not show symptoms. But if it show symptoms then its symptoms resemble with the symptoms of mechanical bowel obstruction. Common symptoms involve abdominal pain, cramps, gas distension and vomiting. Constipation is the most common and visible symptom of adynamic ileus.

Adynamic ileus can occur as a result of metabolic disorder, secondary to drugs, abdominal surgery, abdominal trauma, head injury and sepsis. Imaging of adynamic ileus shows gaseous distension of small and large intestine. If adynamic ileus is localized, then imaging shows sentinel loop. Adynamic ileus is sometimes associated with colicky pains of gall bladder or kidney stones. Treatment involve intubation of intestine via long balloon tipped tube. Because of deficiency of body fluids, fluid supplements are provided to patient in the form of Intravenous fluid administration.

Adynamic Ileus Symptoms

Adynamic ileus is the paralysis of peristaltic movement of intestine. It shows the following symptoms

• Patient feels pain in abdomen.
• Patient feels gaseous distension in his abdomen.
• Constipation is the commonest symptom of adynamic ileus.
• Due to cessation of peristaltic movement, the food is no more moving to colon and rectum. So due to storage of food passage, patient may vomit it out.
• Vomiting sometimes become severe that it may contain fecal matter as well.
• If the obstruction of intestine is not cured, then intestinal circulation may become impaired and as a result patient appear extremely ill.
• In severe condition, patient show symptoms of shock and dehydration.

Adynamic Ileus Causes

There are number of conditions which are responsible for causing adynamic ileus. Some of them are
as follows:

• It can occur secondary to drugs like opioids.
• Sepsis specially due to gram negative bacteria can lead to adynamic ileus.
• Metabolic disorders like hyponatremia may also cause adynamic ileus.
• Retroperitoneal hematoma
• Injury or trauma in head.
• Neuro surgery is the rare cause.
• Congestive heart failure.
• Myocardial infarction.
• Inflammation in the abdominal cavity and peritonitis may lead to adynamic ileus.
• The causes of adynamic ileus are considered complex and multi factorial.

Adynamic Ileus Treatment

There are various treatment techniques which are used according to the symptoms of adynamic ileus. As gaseous distension of intestine is treated via intubation with a long tube balloon tipped tube. Due to disruption of body fluids, the fluid supplements containing glucose, fluids and electrolytes are given Intravenously. If gangerene develops at the site of obstruction then surgery is necessary. The selection of surgical procedure totally depends upon the cause of obstruction and condition of bowel. Commonly ileostomy and colostomy are performed according to the area involved. These surgical procedures may be either temporary or permanent.