Physiological Impact, Clinical Manifestations, and Complications of Postoperative Ileus, and Early Postoperative Small Bowel Obstruction

The physiological impact and complications of postoperative ileus and postoperative bowel obstruction result primarily from the patient's nutritionally compromised state. Patients who fail to rapidly regain nutritional competence after surgery are susceptible to increasing malnutrition in the body's already stressed surgical state. Standard postoperative fluid and electrolyte management is adequate for minimal short-term nutritional requirements in postoperative patients; however, when return to oral intake is delayed, early consideration of nutritional supplementation with parenteral nutrition is essential. Patients with compromised nutritional states, especially the elderly and those with multiple comorbidities, are at increased risk for morbidity and mortality if they experience a sustained postoperative ileus or bowel obstruction. Early identification of patients at risk and prompt intervention with nutritional support can help maintain the body's proper homeostasis and prevent adverse consequences and complications associated with postoperative ileus and bowel obstruction. (C) 2005 Elsevier Inc. All rights reserved.