Paralyzing intestinal obstruction (paralytic ileus)

A crippling intestinal obstruction causes the intestinal movement (peristalsis) to suddenly stop. The intestinal contents can not be transported in the direction of the rectum due to the intestinal paralysis. As with the mechanical intestinal obstruction, the germs contained in the intestinal contents can migrate through the intestinal wall. They enter the abdominal cavity and lead to peritonitis. It comes to a so-called acute belly (acute abdomen).

Paralyzing intestinal obstruction due to peritonitis

Conversely, an existing peritonitis can lead to debilitating intestinal obstruction. Rapid (acute) and long-lasting (chronic) inflammatory processes of the abdominal organs can spread to the abdominal cavity as a result of the wall damage of the affected organ and also cause a severe inflammatory reaction of the abdomen or peritoneal membrane (peritonitis).

Regardless of the cause of peritonitis, as a result of peritonitis, a crippling intestinal obstruction (paralytic ileus) develops. The intestinal loops are no longer able to move intestinal contents.

What causes a paralytic ileus?

At this form of intestinal obstruction the intestinal clearing is not narrowed. The passage of the chair is hampered by metabolic, venom-related or reflex intestinal paralysis (= paralysis).

Particularly inflammatory gastrointestinal diseases lead via peritonitis to a crippling intestinal obstruction:

  • a perforated gastric or small intestinal ulcer (perforated gastric ulcer or duodenal ulcer)
  • Gallbladder inflammation (acute cholecystitis)
  • Pancreatitis (acute pancreatitis)
  • broken inflammation of an intestinal protuberance (perforated diverticulitis)
  • dangerous complication of ulcerative colitis (toxic megacolon)
  • infectious gastrointestinal inflammation (acute infectious gastroenteritis)
  • Appendicitis (acute appendicitis)

Paralytic ileus: other causes

Apart from inflammatory diseases, the occlusion of one of the most important abdominal arteries may be responsible for debilitating intestinal obstruction. From the aorta (main artery) two important arteries drain in the abdomen, which supply blood to almost the entire small and large intestine. These are the upper and lower intestinal artery (superior mesenteric artery and inferior mesenteric artery). Like all arteries in the human body, these too are subject to an arteriosclerotic process in old age. A closure of one of these vessels leads to the so-called mesenteric infarction.

The intestinal tissue, which depends on the mesenteric arteries, can no longer be adequately supplied with blood and oxygen. This serious circulatory disorder leads to the death of the intestine. The intestinal walls become permeable, and the contents of the intestinal loops can migrate unhindered into the abdominal cavity. The peritoneum is inflamed and a paralyzing intestinal obstruction (paralytic ileus) develops.

Mostly older people are affected. Also changes of the blood salts can lead to a crippling intestinal obstruction. Blood salts (electrolytes) are responsible for the fact that the muscles, including the intestinal muscles contract and thus perform the desired movement. Especially changes in the potassium value lead to such changes. Furthermore, as a result of a vertebral fracture, the intestine may react with a (temporary) paralysis. Therefore, patients with vertebral fractures must also take light meals for a few days in order to minimize the risk of intestinal paralysis.

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