View Single Post
  #1 (permalink)  
Old 12-02-2004, 12:39 AM
usmlemate usmlemate is offline
Junior Member
 
Join Date: Nov 2004
Posts: 55
paralytic ileus secondary to generalized peritonitis

A 12-year-old boy has recently had an appendectomy for acute appendicitis. Four days after the operation he developed abdominal distention, absolute constipation, and effortless vomiting. On present examination the patient is anxious and uncomfortable. The abdomen is distended, silent, and tender. A plain x-*** of the abdomen showed gas distributed throughout the small and large gut and some fluid levels were present. He was diagnosed to have advanced paralytic ileus secondary to generalized peritonitis (login to see figure 1). The best treatment in addition to the usual supportive measures would be:

A. High doses of Ilopan and Prostigmin

B. Prompt reoperation to place multiple drains and search for local abscesses

C. Prompt reoperation to drain the obstructed intestine by ileostomy

D. Fibrinolysis to ablate adhesions

E. Intestinal intubation and continuous suction
Reply With Quote