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.1


Ileus is frequently seen in the postoperative period. Narcotic analgesics administered for postoperative pain control may contribute, as can other medications that slow down 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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