RT Journal
A1 Luckey A, Livingston E, Taché Y
T1 MEchanisms and treatment of postoperative ileus
JF Archives of Surgery
JO Archives of Surgery
YR 2003
FD February 1
VO 138
IS 2
SP 206
OP 214
DO 10.1001/archsurg.138.2.206
UL http://dx.doi.org/10.1001/archsurg.138.2.206
AB Objective 
    To review the pathogenesis and treatment of postoperative ileus.Data Sources 
    Data collected for this review were identified from a MEDLINE database search of the English-language literature. The exact indexing terms were "postoperative ileus," "treatment," "etiology," and "pathophysiology." Previous review articles and pertinent references from those articles were also used.Study Selection 
    All relevant studies were included. Only articles that were case presentations or that mentioned postoperative ileus in passing were excluded.Data Synthesis 
    The pathogenesis of postoperative ileus is complex, with multiple factors contributing either simultaneously or at various times during the development of this entity. These factors include inhibitory effects of sympathetic input; release of hormones, neurotransmitters, and other mediators; an inflammatory reaction; and the effects of anesthetics and analgesics. Numerous treatments have been used to alleviate postoperative ileus without much success.Conclusions 
    The etiology of postoperative ileus can best be described as multifactorial. A multimodality treatment approach should include limiting the administration of agents known to contribute to postoperative ileus (narcotics), using thoracic epidurals with local anesthetics when possible, and selectively applying nasogastric decompression.