Adynamic ileus may involve the cecum or the entire large bowel following surgery. This can often be recognized on imaging studies of the abdomen. Prompt decompression can significantly reduce the risk of perforation, which may be fatal.
Features of cecal or colonic ileus:
(1) gross distension of the cecum and/or colon to >= 10 cm
(2) adynamic ileus also is present in the small intestine
(3) exclusion of mechanical obstruction
The bowel distension is mostly due to intraluminal gas, with little fluid or stool.
The risk of perforation increases with duration of the ileus. Perforation did not occur if the duration was less than 2 days (very low risk(. A duration of 5 or more days was usually associated with perforation (high risk). A duration of 2 to 4 days may or may not be associated with perforation (low to moderate risk).
A contrast enema should be avoided since it can worsen the patient's condition by increasing the bowel distension.
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