<unk>  is defined as the temporary cessation of intestinal peristalsis in the absence of mechanical obstruction. The word<unk>  is derived from the Greek word "είλειν" which means to twist. There is no specific system for classification of postoperative<unk> . However, based on etiology, postoperative<unk>  may be classified into drug induced<unk> ,<unk>  secondary to metabolic and electrolyte disturbances and<unk>  due to some systemic disorders. The pathogenesis of<unk>  is based on its multifactorial etiology.<unk>  is most commonly seen during the postoperative period (usually 3 days after surgery). Commonly used analgesics such as opiates and anesthesia may also aggravate the development of<unk> . Enteric and autonomic nervous system disturbances can cause a severe variety of<unk> , named chronic intestinal pseudo-obstruction (CIPO), which may be related to some altered genes. Conditions commonly associated with<unk>  include diabetes mellitus, hypothyroidism, and hypoparathyroidism.  The incidence and prevalence of<unk>  varies with the type of surgery performed. The incidence of<unk>  in patients undergoing laparotomy is approximately 9,000 per 100,000 cases worldwide, which is more common compared to other surgeries. Common risk factors in the development of<unk>  include older age, electrolyte abnormalities, previous history of abdominal surgery, postoperative deep venous thrombosis, diabetic ketoacidosis, history of chronic opiates use and hypothyroidism. Patients with<unk>  are usually presented with abdominal pain, abdominal distention, nausea and vomiting with postprandial discomfort, constipation or obstination and loss of appetite. Common complications of<unk>  include electrolyte imbalance, dehydration, intestinal perforation, sepsis, jaundice, Intestinal strangulation and pulmonary complications. There are no diagnostic laboratory findings associated with<unk> . However, laboratory evaluations must be done to identify the severity and presence of other complications of<unk>  such as electrolyte abnormalities and hypovolemia. Findings on an x-ray suggestive of<unk>  include multiple air–fluid levels throughout the abdomen, elevated diaphragm with dilatation of both large and small intestine, slow movement of barium with a patent intestinal lumen. An abdomen and pelvis CT scan (with intravenous contrast and oral water soluble contrast) can also distinguish early postoperative<unk>  from mechanical obstruction. In addition, a CT scan can also identify other complications seen in the postoperative period or<unk>  related complications, such as perforation, strangulation and necrosis. Intravenous hydration is advised with appropriate rapid supplementation for electrolyte abnormalities. NSAIDs are used as baseline analgesic medications. Patients are put on NPO and nasogastric tube is advised to relieve recurrent vomiting or abdominal distention associated with pain. Surgical intervention is not routinely recommended for the management of<unk> . However, patients with prolonged<unk> , radiologic or clinical findings indicating development of<unk>  complication, such as intestinal perforation, strangulation or necrosis and worsening of clinical or laboratory conditions of patients may require urgent surgical intervention to identify and alleviate complications of<unk> .
Ileus
Gallstone ileus
Ileitis
Chronic cholecystitis
Fecaloma
Acute cholecystitis
Pancreatic fistula
Acute pancreatitis