Andrew L. Wong, MD

April 01, 2002

This obstruction is caused by a failure of intestinal peristalsis;there is no evidence of mechanical obstruction.Paralytic ileus is common after abdominal surgery, especiallyif anticholinergic drugs are given preoperativelyand/or narcotics are used postoperatively. It usually lasts2 to 3 days. Paralytic ileus may also be caused by peritonitis;ischemia or surgical manipulation of the bowel; retroperitonealhemorrhage; spinal fracture; systemic sepsis;shock; hypokalemia; uremia; pharmacologic agents (eg,vincristine, loperamide, and calcium channel blockers);diabetic ketoacidosis; and myxedema.

March 01, 2002

This obstruction results from hypertrophyof the circular and longitudinalmuscularis of the pylorus and the distalantrum of the stomach. It occursin approximately 3 of every 1000 livebirths and is 4 times more commonin boys. Pyloric stenosis (PS) is relativelyuncommon in African Americanand Asian infants. The observationthat it occurs primarily in first-borninfants has been disputed.

March 01, 2002

Adhesions (A) can form within theperitoneal cavity after abdominalsurgery, especially if there is an underlyinginflammatory condition suchas appendicitis (B) or inflammatorybowel disease. The incidence of adhesiveintestinal obstruction following alaparotomy is approximately 2%. Mostadhesive obstructions occur within 3months of the laparotomy, and 80%occur within 2 years. Adhesive obstructionstend to be more commonin children than in adults.