Ileus LBO

 abdominal emergency
Adynamic: with high morbidity and
 Pseudo-obstruction, dilatation of the colon without mortality rates if left
mechanical obstruction, can occur as a result of adynamic untreated
ileus, ACPO (also known as Ogilvie syndrome), or toxic  Adominal radiography
megacolon.  initial imaging study
 diffuse small- and large-bowel dilatation without a transition performed in patients
point suspected of having
 recent gastrointestinal surgery, recent opiate use, critical large-bowel obstruction
illness, neurologic disorders, and metabolic disturbances  not be sufficient to
 Colonic distension due to these entities usually occurs with distinguish obstruction
minimal fluid; the presence of air-fluid levels should raise the from other causes of
suspicion of an obstruction colonic dilatation.
 T has become the preferred imaging study for evaluation of  CT scan
LBO, there are some indications for performing a contrast  imaging
enema. The major advantage of the contrast enema is that it method of
usually allows easy distinction between a LBO and colon choice as it can
pseudo-obstruction establish the
https://pubs.rsna.org/doi/full/10.1148/radiol.2015140916 diagnosis and
cause of large-
bowel
obstruction.
 A contrast agent enema
 confirm or
exclude large-
bowel
obstruction.
 often acute and
includes abdominal
pain, constipation or
obstipation, and
abdominal distension
 LBO is four to five
times less frequent
than SBO and the
causes of LBO and SBO
differ substantially
 Colonic malignancy
remains the most
common (> 60%)
 Additional causes:
diverticulitis, colonic
volvulus, and
adhesions.
 Colonic obstruction is
 most often seen in
elderly individuals, as
the aforementioned
causes of obstruction
are more common in
advanced age groups
 elderly and the signs
and symptoms of LBO
are often insidious
 difficult to distinguish
between obstruction
and colonic pseudo-
obstruction in a patient
with a distended colon

 Bloated abdomen

 Abdominal pain, which

can be either vague and mild,
or sharp and severe,
depending on the cause of the
obstruction

 Constipation at the time

of obstruction, and possibly
intermittent bouts of
constipation for several
months beforehand

 If a colon tumor is the

cause of the problem, a
history of rectal bleeding
(such as streaks of blood on
the stool)

 Diarrhea resulting from

liquid stool leaking around a
partial obstruction

https://www.health.harvard.ed
u/a_to_z/bowel-obstruction-a-
to-z