Ileus, tarmobstruktion
Senast reviderad:
Sakkunnig:Anna Nager
Definition:
Akut obstruktion av tunntarmen eller tjocktarmen uppstår när tarminnehållets rörelse ner i tarmen förhindras.
Förekomst:
Orsakar cirka 6–15 % av alla inläggningar för akuta buksmärtor.
Symtom:
Typiska symtom är koliksmärta, illamående och kräkningar, utspänd buk, upphörande av gasavgång och tarmrörelser.
Kliniska fynd:
Utspänd buk, palpationsömhet över buken, högfrekventa tarmljud eller få tarmljud.
Diagnostik:
DT-buk i första hand.
Behandling:
Avlasta tarmen och ta bort orsaken till obstruktionen, eventuellt kirurgi.
- Jackson PG, Raiji M. Evaluation and management of intestinal obstruction. Am Fam Physician 2011; 83: 159-65. PMID: 21243991 PubMed
- Bjerkeset T, Havik S, Aune KE, Rosseland A. Akutte buksmerter som årsak til innleggelse Acute abdominal pain as cause of hospitalisation. Tidsskr Nor Laegeforen. 2006;126(12):1602-160. PMID: 16770370 PubMed
- Drożdż W, Budzyński P. Change in mechanical bowel obstruction demographic and etiological patterns during the past century: observations from one health care institution. Arch Surg. 2012 Feb;147(2):175-80. doi: 10.1001/archsurg.2011.970. PMID: 22351915 PubMed
- Gastrokirurgisk metodebok. Ileus. Oslo Universitetssykehus. Siden besøkt 28.02.2020. ehandboken.ous-hf.no
- Maung AA, Johnson DC, Piper GL, et al. Evaluation and management of small-bowel obstruction: An Eastern Association for the Surgery of Trauma practice management guideline. J Trauma Acute Care Surg 2012; 73: S362-S369. PMID: 23114494 PubMed
- Catena F, Di Saverio S, Kelly MD, et al. Bologna Guidelines for Diagnosis and Management of Adhesive Small Bowel Obstruction (ASBO): 2010 Evidence-Based Guidelines of the World Society of Emergency Surgery. World J Emerg Surg 2011; 6: 1-24. PubMed
- Zielinski MD, Eiken PW, Bannon MP, et al. Small bowel obstruction-who needs an operation? A multivariate prediction model. World J Surg 2010; 34: 910-9. PubMed
- Hayanga AJ, Bass-Wilkins K, Bulkley GB. Current management of small-bowel obstruction. Adv Surg 2005; 39: 1-33. PubMed
- Choi HK, Chu KW, Law WL. Therapeutic value of gastrografin in adhesive small bowel obstruction after unsuccessful conservative treatment: a prospective randomized trial. Ann Surg 2002; 236: 1-6. PubMed
- Maglinte DD, Heitkamp DE, Howard TJ, Kelvin FM, Lap-pas JC. Current concepts in imaging of small bowel obstruction. Radiol Clin North Am 2003; 41: 263-83. PubMed
- Abbas S, Bissett IP, Parry BR. Oral water soluble contrast for the management of adhesive small bowel obstruction. Cochrane Database of Systematic Reviews 2007, Issue 3. Art. No.: CD004651. DOI: 10.1002/14651858.CD004651.pub3. PMID: 17636770 PubMed
- Mosley JG, Shoaib A. Operative versus conservative management of adhesional intestinal obstruction. Br J Surg 2000; 87: 362-73. PubMed
- Fevang BT, Jensen D, Svanes K, Viste A. Early operation or conservative management of patients with small bowel obstruction? Eur J Surg 2002; 168: 475-81. PubMed
- Williams SB, Greenspon J, Young HA, Orkin BA. Small bowel obstruction: conservative vs. surgical management. Dis Colon Rectum 2005; 48: 1140-6. PubMed
- Kendrick ML. Partial small bowel obstruction: clinical issues and recent technical advances. Abdom Imaging 2009; 34:329. PubMed
- Anna Nager, docent och specialist i allmänmedicin, Karolinska institutet
- Terje Johannessen, professor i allmennmedisin, Trondheim