Description ileum
Ileus or bowel obstruction is a very serious, life-threatening condition that can involve both the small and the large intestine.Because the patient is always a potential threat to life, it must be immediately addressed in the surgical ward.
Risk factors for ileus
According to the causes of ileus are divided into three types: mechanical, neurogenic and vascular. Another division describes the site where blockage occurs, ie high (the area between the stomach and the small intestine or beginning of the small intestine) and low (second half of the small intestine and colon).
Mechanical ileus occurs in disorders in the intestine or in its immediate vicinity, which lead to constriction or closure of its lumen. Barrier inside the intestine can represent a foreign body which man accidentally swallowed, gallstone and rarely propagate parasites, especially roundworms. In elderly or bedridden patients with longstanding constipation can cause bowel obstruction of stool in the gut. The cause of the ileum also form barriers situated right in the gut wall – it is mostly polyps (growths), tumors, also resulting scars after surgery, or inflammation of the intestine. Obstacle outside the intestine may represent a tumor which grows close to the intestine and exerts pressure closes the lumen also different adhesions in the abdominal cavity, which remains there as a result of inflammation or operations. Now postoperative adhesions represent absolutely the most frequent reasons for the creation of ileus.
When mechanical ileus also associated with impaired blood supply to the intestines, we talk about strangulation (strangulation) intestine. It typically occurs when the bowel loop strangulated hernia in what is a bulge of peritoneum through the slit in the abdominal wall.
Neurogenic ileus is caused by damage to the signal transmission between nerves stored in the muscle wall of the gut and intestines ensuring its movements (peristalsis). Usually there is a flaccid muscle intestine (Paralytic ileus) that occurs when the total heavy state – inflammations in the abdominal cavity (inflammation of the pancreas, peritoneum, kidney, gall bladder), in spine fractures, in renal and biliary colic, when large blood losses.
Very rare is called spastic ileus, when the muscle of the intestinal wall gets into spasm, and is unable to relax and thereby move intestinal contents further. This may occur with lead poisoning, or in the last stages of untreated syphilis (syphilis).
The least common cause of vascular occlusion is disorder, that vessel. As a result of impaired blood supply to the bowel (intestine clogged arteries supplying blood clot), or its insufficient drainage of the intestinal wall of the lack of oxygen and will cease to move and move further intestinal contents.
prevention ileum
Because the most common cause of intestinal obstruction caused by adhesions represent in the vicinity of the intestine after various surgeries, surgeons constantly trying new ways of surgery and postoperative care of patients, which may contribute to the prevention of ileus in the future.
For elderly and immobile people especially need to monitor their state of hydration, what is easily found by looking into their oral cavity. When the mucous membranes and tongue moist, pink and shiny, hydration is fine. But when he appears on the tongue and mucous coating are visibly dried-up, it is necessary to increase fluid intake. Constipation lasting more than three days is necessary to visit a doctor.
symptoms of ileus
Ileus may vary depending on the cause of its formation manifest differently. Typical warning signs of the disease development, however, are: pledge flatulence and stool, whether due to obstacles or pledge peristalsis. In the intestine and leads to their accumulation of what causes stretching the intestines, which occur abdominal bloating. Since food is due to the obstacle which block the intestine can not move further, there is a restless vomiting. These symptoms are accompanied bystrong boles t, which can have colicky in nature (comes in waves, stepped up to the maximum, then fading again intensifies), or it may be permanent, cruel and inconsolable – as is the case with strangulačního ileum, the colon suffers lack of oxygen. In most dangerous strangulačního ileum may also experience symptoms of incipient shock – that is, restlessness, or vice versa, severe drowsiness, pale skin with cold sweat, rapid heart rate, rapid breathing.
treatment ileum
If these symptoms, or at least some of them appear, it is necessary as soon as possible to come to the hospital for surgery department. The doctor removes from the patient or his entourage history, examine the patient’s abdomen. Subsequently uses some of imaging techniques – most often makes the image the abdomen in a standing position, but also abdominal ultrasound or CT scan.
Ileus treatment is surgical in most cases, immediate surgery may be lifesaving. Only in exceptional cases are chosen so-called conservative, ie non-surgical treatment. Then through the nose introduced into the stomach of a patient a probe, which will be fed, they must also have the infusion in a vein and urinary catheter, which is led into the urine collection bag and thus controls its fluid output. The doctor will also prescribe a gentle laxative that gets stagnant intestinal contents from outside the body.
How can I help myself
The only help when developing symptoms of intestinal obstruction is of immediate medical assistance.
complications ileum
Unsolved or solved late intestinal obstruction can lead to death of the patient. Enhanced intestinal loops, which are filled with feces and gas, are very fragile and can easily perforate. Their contents are then poured into the abdominal cavity and cause peritonitis – thus peritonitis. It is a very serious condition that is difficult to treat and can be up to half of the cases can lead to death.
With the accumulation of fluids in the intestine, its deficiency in other parts of the body begin to show failure bloodstream. This leads to the subsequent multi-organ failure (kidney, liver), without which human activity is likely to survive. At deterioration also have a proportion of proliferating bacteria in the intestines and produce toxins. These, easily penetrate through the intestinal wall weakened, first stretching and secondly impaired blood supply. Thus cause severe overall reactions that end up in most cases, death.
Other names: Intestinal obstruction
