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Acute Intestinal Pseudo-Obstruction (Ileus)

Acute Intestinal Pseudo-Obstruction (Ileus) is a topic covered in the Washington Manual of Medical Therapeutics.

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General Principles


  • Acute intestinal pseudo-obstruction or ileus consists of impaired transit of intestinal contents and obstructive symptoms (nausea, vomiting, abdominal distension, lack of bowel movements) without a mechanical explanation.
  • Acute colonic pseudo-obstruction or Ogilvie syndrome describes massive colonic dilation without mechanical obstruction in the presence of a competent ileocecal valve, resulting from impaired colonic peristalsis (Br J Surg 2009;96:229  [PMID:19224517]).


Ileus is frequently seen in the postoperative period. Narcotic analgesics administered for postoperative pain control may contribute, as can other medications that slow intestinal peristalsis (calcium channel blockers, anticholinergic medications, TCAs, antihistamines). Other predisposing causes include virtually any medical insult, particularly life-threatening systemic diseases, infection, vascular insufficiency, and electrolyte abnormalities. Etiology is similar for acute colonic pseudo-obstruction.

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Williams, Dominique, et al., editors. "Acute Intestinal Pseudo-Obstruction (Ileus)." Washington Manual of Medical Therapeutics, 35th ed., Wolters Kluwer Health, 2016. Washington Manual, www.unboundmedicine.com/washingtonmanual/view/Washington-Manual-of-Medical-Therapeutics/602302/0.0/Acute_Intestinal_Pseudo_Obstruction__Ileus_.
Acute Intestinal Pseudo-Obstruction (Ileus). In: Williams D, Ramgopal R, Gdowski M, et al, eds. Washington Manual of Medical Therapeutics. 35th ed. Wolters Kluwer Health; 2016. https://www.unboundmedicine.com/washingtonmanual/view/Washington-Manual-of-Medical-Therapeutics/602302/0.0/Acute_Intestinal_Pseudo_Obstruction__Ileus_. Accessed June 19, 2019.
Acute Intestinal Pseudo-Obstruction (Ileus). (2016). In Williams, D., Ramgopal, R., Gdowski, M., Dretler, A., & Bhat, P. (Eds.), Washington Manual of Medical Therapeutics. Available from https://www.unboundmedicine.com/washingtonmanual/view/Washington-Manual-of-Medical-Therapeutics/602302/0.0/Acute_Intestinal_Pseudo_Obstruction__Ileus_
Acute Intestinal Pseudo-Obstruction (Ileus) [Internet]. In: Williams D, Ramgopal R, Gdowski M, Dretler A, Bhat P, editors. Washington Manual of Medical Therapeutics. Wolters Kluwer Health; 2016. [cited 2019 June 19]. Available from: https://www.unboundmedicine.com/washingtonmanual/view/Washington-Manual-of-Medical-Therapeutics/602302/0.0/Acute_Intestinal_Pseudo_Obstruction__Ileus_.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Acute Intestinal Pseudo-Obstruction (Ileus) ID - 602302 ED - Williams,Dominique, ED - Ramgopal,Rajeev, ED - Gdowski,Mark, ED - Dretler,Alexandra, ED - Bhat,Pavat, BT - Washington Manual of Medical Therapeutics UR - https://www.unboundmedicine.com/washingtonmanual/view/Washington-Manual-of-Medical-Therapeutics/602302/0.0/Acute_Intestinal_Pseudo_Obstruction__Ileus_ PB - Wolters Kluwer Health ET - 35 DB - Washington Manual DP - Unbound Medicine ER -