Ways to prevent ileus

Summary The prevention of ileus probably starts well before the surgery begins, with timely referral, diagnosis and intervention in the horse with surgical colic. Attempts to decrease the likelihood of ileus, which is often related to the degree of inflammation and critical illness level of the patient, should occur at each step of the management of the surgical colic patient, from the decision to treat the horse surgically to reintroduction of feed. Surgical factors that may influence ileus include how quickly the bowel is decompressed and the lesion is resolved, and how the bowel is handled and lubricated during correction. Persistent distension of the small intestine likely results in bowel stasis post-operatively. During surgery, a reasonable balance must be found between decompressing the small intestine to prevent ileus and overhandling the bowel. It is important to keep the bowel moist and well-lubricated throughout the surgical correction; warm, pH balanced lavage solution and carboxymethylcellulose can be used to minimise bowel inflammation and trauma during handling. The abdomen should be thoroughly lavaged if the peritoneal fluid is significantly serosanguinous, or if intra-abdominal haemorrhage has occurred secondary to the primary lesion ...