paralytic ileus vs small bowel obstruction


On xray, paralytic ileus can have colon dilation.

SBO on xray does not have colon dilation.

Management

  • in general SBO requires NG for decompression
  • paralytic ileus does not require NG. However, stopping tube feeds clinically may be needed
  • erythromycin is not effective for ileus
  • neostigmine can be used for colonic dilation or pseudo-obstruction
  • limit opioids
  • can try enteral naloxone1

Footnotes

  1. https://emcrit.org/ibcc/ileus/