Ileus Differential Diagnosis
The differential diagnosis for ileus can be organized into the following categories:
- Single Most Likely Diagnosis
- Postoperative ileus: This is the most common cause of ileus, especially after abdominal surgery. It is a temporary condition where there is a slowing or stopping of the normal contractions of the bowel muscles.
- Other Likely Diagnoses
- Adhesions: These are bands of fibrous tissue that can form between loops of intestine or between the intestine and other organs, leading to bowel obstruction and ileus.
- Infection (e.g., pneumonia, urinary tract infection): Severe infections can cause ileus, especially in elderly or critically ill patients.
- Medications (e.g., narcotics, anticholinergics): Certain medications can slow down bowel motility, leading to ileus.
- Electrolyte imbalance (e.g., hypokalemia, hypomagnesemia): Abnormal electrolyte levels can affect bowel function and lead to ileus.
- Do Not Miss Diagnoses
- Mesenteric ischemia: This is a life-threatening condition where the blood flow to the intestine is compromised, leading to ischemia and potential necrosis.
- Volvulus: This is a condition where a loop of intestine twists around its base, cutting off blood flow and leading to ischemia.
- Intussusception: This is a condition where a segment of intestine telescopes into another segment, leading to bowel obstruction and potential ischemia.
- Sigmoid volvulus: This is a type of volvulus that occurs in the sigmoid colon and can lead to bowel obstruction and ischemia.
- Rare Diagnoses
- Chronic intestinal pseudo-obstruction: This is a rare condition where there is a persistent impairment of the muscle contractions that move food, fluid, and air through the intestines.
- Hirschsprung's disease: This is a rare congenital condition where there is a lack of nerve cells in the colon, leading to chronic constipation and potential ileus.
- Amyloidosis: This is a rare condition where abnormal proteins accumulate in the body, potentially affecting the intestine and leading to ileus.
- Scleroderma: This is a rare autoimmune condition that can affect the intestine and lead to ileus.