WordNet

affected with paralysis (同)paralyzed
a person suffering from paralysis
relating to or of the nature of paralysis; "paralytic symptoms" (同)paralytical

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麻痺した,中風の;《英話》泥酔した / 〈C〉中風患者

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2017/02/11 05:50:21」(JST)

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Ileus is a disruption of the normal propulsive ability of the gastrointestinal tract. Although ileus originally referred to any lack of digestive propulsion, including bowel obstruction,^[1]^[2] up-to-date medical usage restricts its meaning to those disruptions caused by the failure of peristalsis, rather than by mechanical obstruction.^[3]^[4] Although certain older terms such as gallstone ileus and meconium ileus persist in usage, they are now misnomers^[5] (which does not mean that they are incorrect or obsolete, but rather that they are known to not sound like what they really are).

The word ileus is from Greek εἰλεός eileós, "intestinal obstruction".

Signs and symptoms

Symptoms of ileus include, but are not limited to:

moderate, diffuse abdominal discomfort
constipation
abdominal distension
nausea/vomiting, especially after meals
vomiting of bilious fluid
lack of bowel movement and/or flatulence
excessive belching

Cause

Decreased propulsive ability may be broadly classified as caused either by bowel obstruction or intestinal atony or paralysis. However, instances with symptoms and signs of a bowel obstruction occur, but with the absence of a mechanical obstruction, mainly in acute colonic pseudo-obstruction, Ogilvie's syndrome.

Bowel obstruction

A bowel obstruction is generally a mechanical obstruction of the gastrointestinal tract.

Intestinal paralysis

Paralysis of the intestine is often termed paralytic ileus, in which the intestinal paralysis need not be complete, but it must be sufficient to prohibit the passage of food through the intestine and lead to intestinal blockage. Paralytic ileus is a common side effect of some types of surgery, commonly called postsurgical ileus. It can also result from certain drugs and from various injuries and illnesses, such as acute pancreatitis. Paralytic ileus causes constipation and bloating. On listening to the abdomen with a stethoscope, no bowel sounds are heard because the bowel is inactive.

A temporary paralysis of a portion of the intestines occurs typically after abdominal surgery. Since the intestinal content of this portion is unable to move forward, food or drink should be avoided until peristaltic sound is heard, by auscultation (use of a stethoscope) of the area where this portion lies. Intestinal atony or paralysis may be caused by inhibitory neural reflexes, inflammation or other implication of neurohumoral peptides.

Risk factors

gastrointestinal surgery or other GI procedures
electrolyte imbalance (Namely hypokalemia and hypercalcemia)
diabetic ketoacidosis (DKA),^[6] and other causes of metabolic acidosis
hypothyroidism
medications (e.g. opiates or antimuscarinics)
severe illness (Inflammation with peritonitis)
spinal cord injury, those with injury above thoracic vertebrae 5 (T5) will have hypomotility problems within the bowel

Treatment

Traditionally, nothing by mouth was considered to be mandatory in all cases, but gentle feeding by enteral feeding tube may help to restore motility by triggering the gut's normal feedback signals, so this is the recommended management initially.^[7] When the patient has severe, persistent signs that motility is completely disrupted, nasogastric suction and parenteral nutrition may be required until passage is restored. In such cases, continuing aggressive enteral feeding causes a risk of perforating the gut.

Several options are available in the case of paralytic ileus. Most treatment is supportive. If caused by medication, the offending agent is discontinued or reduced. Bowel movements may be stimulated by prescribing lactulose, erythromycin or, in severe cases that are thought to have a neurological component (such as Ogilvie's syndrome), neostigmine. There is also evidence from a systematic review of randomized controlled trials that chewing gum, as a form of 'sham feeding', may stimulate gastrointestinal motility in the post-operative period and reduce the duration of postoperative ileus.^[8]

If possible the underlying cause is corrected (e.g. replace electrolytes).

Other animals

Ileus is a cause of colic in horses due to functional obstruction of the intestines. It most commonly seen in horses postoperatively, especially following colic surgery.^[9] Horses experiencing ileus are at risk for gastric rupture due to rapid reflux build-up, and require intense medical management with frequent nasogastric intubation.^[9] Ileus may increase adhesion formation, because intestinal segments have more prolonged contact and intestinal distention causes serosal injury and ischemia. It is usually treated with aggressive fluid support, prokinetics, and anti-inflammatories.^[9]

References

^ thefreedictionary.com > Ileus Citing:
- Dorland's Medical Dictionary for Health Consumers. 2007
- The American Heritage Medical Dictionary Copyright 2007
- Mosby's Medical Dictionary, 8th edition. 2009
- Saunders Comprehensive Veterinary Dictionary, 3 ed. 2007
^ Merriam-Webster's medical dictionary. Retrieved Nov, 9, 2010
^ Townsend CM, Beauchamp RD, Evers BM, Mattox KL (2004). "The biological basis of modern surgical practice". Sabiston Textbook of Surgery (17th ed.). Elsevier Saunders.
^ Livingston EH, Passaro EP (January 1990). "Postoperative ileus". Dig. Dis. Sci. 35 (1): 121–32. doi:10.1007/bf01537233. PMID 2403907.
^ Feldman M, Friedman LS, Brandt LJ, Sleisenger MH (2006). "Intestinal Obstruction and Ileus". Sleisenger & Fordtran's Gastrointestinal and Liver Disease (8th ed.). Elsevier Saunders.
^ Kitabchi AE, Umpierrez GE, Murphy MB, et al. (January 2001). "Management of hyperglycemic crises in patients with diabetes". Diabetes Care. 24 (1): 131–53. doi:10.2337/diacare.24.1.131. PMID 11194218.
^ McClave SA, Martindale RG, Vanek VW, et al. (2009). "Guidelines for the Provision and Assessment of Nutrition Support Therapy in the Adult Critically Ill Patient: Society of Critical Care Medicine (SCCM) and American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.)". JPEN J Parenter Enteral Nutr. 33 (3): 277–316. doi:10.1177/0148607109335234. PMID 19398613.
^ Fitzgerald JE, Ahmed I (December 2009). "Systematic review and meta-analysis of chewing-gum therapy in the reduction of postoperative paralytic ileus following gastrointestinal surgery". World J Surg. 33 (12): 2557–66. doi:10.1007/s00268-009-0104-5. PMID 19763686.
^ ^a ^b ^c Larson, Erica. "Equine Postoperative Ileus Insights". www.thehorse.com. The Horse. Retrieved 4 July 2014.

External links

MedlinePlus Encyclopedia Intestinal Obstruction
Patient UK: Intestinal Obstruction and Ileus
PubMed Health: Intestinal obstruction
Ileus at eMedicine
Merck Manual Professional: Ileus

UpToDate Contents

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1. 術後イレウス postoperative ileus
2. 成人における機械的小腸閉塞の疫学、臨床的特徴、および診断 epidemiology clinical features and diagnosis of mechanical small bowel obstruction in adults
3. 長期にわたる術後イレウスに対する予防策 measures to prevent prolonged postoperative ileus
4. 成人における特発性細菌性腹膜炎：臨床症状 spontaneous bacterial peritonitis in adults clinical manifestations
5. 機械的大腸閉塞の概要 overview of mechanical colorectal obstruction

English Journal

Variants of the ACTG2 gene correlate with degree of severity and presence of megacystis in chronic intestinal pseudo-obstruction.

Matera I1, Rusmini M1, Guo Y2, Lerone M1, Li J3, Zhang J3, Di Duca M4, Nozza P5, Mosconi M6, Pini Prato A6, Martucciello G6,7, Barabino A8, Morandi F9, De Giorgio R10, Stanghellini V10, Ravazzolo R1,7, Devoto M11,12,13, Hakonarson H2, Ceccherini I1.
European journal of human genetics : EJHG.Eur J Hum Genet.2016 Aug;24(8):1211-5. doi: 10.1038/ejhg.2015.275. Epub 2016 Jan 27.
Chronic intestinal pseudo-obstruction (CIPO) syndromes are heterogeneous gastrointestinal disorders, caused by either neuropathy or myopathy, resulting in compromised peristalsis and intestinal obstruction. CIPO can have a profound impact on quality of life, leading the most severely affected indivi
PMID 26813947

A Novel Mutation in Nucleoporin 35 Causes Murine Degenerative Colonic Smooth Muscle Myopathy.

Parish IA1, Stamp LA2, Lorenzo AM3, Fowler SM3, Sontani Y4, Miosge LA4, Howard DR4, Goodnow CC5, Young HM6, Furness JB2.
The American journal of pathology.Am J Pathol.2016 Jul 15. pii: S0002-9440(16)30169-9. doi: 10.1016/j.ajpath.2016.04.016. [Epub ahead of print]
Chronic intestinal pseudo-obstruction (CIPO) is a rare but life-threatening disease characterized by severe intestinal dysmotility. Histopathologic studies in CIPO patients have identified several different mechanisms that appear to be involved in the dysmotility, including defects in neurons, smoot
PMID 27427419

Gastrointestinal and liver infections in children undergoing antineoplastic chemotherapy in the years 2000.

Castagnola E1, Ruberto E1, Guarino A1.
World journal of gastroenterology.World J Gastroenterol.2016 Jul 7;22(25):5853-66. doi: 10.3748/wjg.v22.i25.5853.
AIM: To review gastrointestinal and liver infections in children undergoing antineoplastic chemotherapy. To look at gut microflora features in oncology children.METHODS: We selected studies published after year 2000, excluding trials on transplanted pediatric patients. We searched English language p
PMID 27433098

Japanese Journal

Kugel法による鼠径ヘルニア術後に大腸穿通を来した盲腸憩室炎の1例

塩谷猛,野村聡,渡邉善正,南部弘太郎,青笹季文,山田太郎,渋谷哲男,柳本邦雄,徳永昭,田尻孝
日本消化器外科学会雑誌 43(1), 90-94, 2010-01-01
症例は69歳の男性で,主訴は右下腹部腫瘤.約2年前に,Kugel法による右鼠径ヘルニア手術を他院で受けていた.小児期の鼠径ヘルニア手術,急性虫垂炎手術の既往があった.CT,注腸検査で右側結腸憩室炎による膿瘍形成を疑い,手術を行った.回盲部が腹壁に強固に癒着しており,剥離するとメッシュが盲腸に癒着,穿通し一塊となり腫瘤を形成していた.メッシュを取り除き,回盲部切除術を行った.病理組織では膿瘍内に放線 …
NAID 110007503960

腹筋麻痺と麻痺性イレウスを合併した帯状疱疹の1例 (特集ウイルス感染症)

木村雅明,樋口哲也,若林知江 [他]
皮膚科の臨床 52(12), 1799-1801, 2010-11
NAID 40017371166

Related Pictures

★リンクテーブル★

リンク元	「ビンクリスチン」「麻痺性イレウス」「idiopathic intestinal pseudo-obstruction」「visceral myopathy」
関連記事	「paralytic」

「ビンクリスチン」

Ileus
	A gangrenous ileus
Pronunciation	/ˈɪliəs/
Classification and external resources
Specialty	General surgery
ICD-10	K31.5, K56.0, K56.3, K56.7, P75, P76.1
ICD-9-CM	537.2, 560.1, 560.31, 777.1, 777.4
DiseasesDB	6706
MedlinePlus	000260
eMedicine	article/178948
Patient UK	Ileus
MeSH	D045823
	[edit on Wikidata]

　　[★]

英: vincristine, VCR
同: 硫酸リューロクリスチン leurocristine sulfate
化: 硫酸ビンクリスチン vincristine sulfate　
商: ONCO-TCS、ONCOVIN、VINCASAR PFS、オンコビン oncovin
関

first aid step1 2006 p.84,310

特徴

ビンカアルカロイドの一つで、チューブリンに結合して微小管の重合(紡錘体の形成を含む)を阻害して細胞増殖を抑制する。　⇔ (パクリタキセルは微小管の脱重合を阻害)

構造

ビンカアルカロイド

作用機序

M-phase-specific alkaloids that bind to tubulin and block polymerization of microtubules so that mitotic spindle cannot form (first aid step1 2006 p.310)

適応

part of the MOPP (Oncovin [vincristine]) regimen for lymphoma, Wilms' tumor, choriocarcinoma(first aid step1 2006 p.310)
MAPP regimen for Hodgkin disease, ALL lymphoma, CNS tumer, sarcoma, Wilms tumor