Paralytic Ileus

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  • A common condition.
  • Occurs following trauma or abdominal surgery.
  • Stasis of gut flow due to failure of peristalsis.
    • Leads to distension with gas and fluid, as well as a flaccid intestinal wall.
Causes
  • Anything which stops peristalsis, e.g.
    • Damage to nerve supply to intestine (autonomic nervous system)
    • Pain
    • Abnormal metabolism
    • Toxaemia
    • Electrolyte imbalance such as hypocalcaemia, hypomagnesaemia, and hypokalaemia.
  • Also in
    • Diabetes mellitus
    • Uraemia
    • Tetanus
    • Lead poisoning.
Pathology
  • loss of smooth muscle tone leads to a flaccid bowel.
  • Bowel is distended with fluid.
Pathogenesis
  • Intestine susceptible to neurogenic damage during an operation.
  • Peristalsis fades away over a few days producing paralytic (adynamic) ileus.
  • Particularly occurs if bowel handled roughly, or if serosa gets cold and dry at surgery.
  • Very difficult to start peristalsis again but will sometimes respond to pharmacological or electrical stimulation.
  • The horse is very susceptible, and the dog is somewhat suscpeitble.