Ileus - Have We Learnt Anything Recently?

Back to basics – what is the present definition of ileus?

Post operative ileus in the horse is a syndrome related to abnormal small intestinal motility because it is identified on the basis of gastrointestinal reflux (Holcombe et al. 2009; Torfs et al. 2009). Therefore, although there are horses with abnormal large intestinal motility following colic surgery, the term post operative ileus has not included these cases in most studies. The criteria for defining ileus vary widely (Merritt and Blikslager 2008). One study regarded any horse with >2 l reflux to have post operative ileus, whereas another study defined cases of post operative ileus as horses with >20 l during a 24 h period, or >8 l during any single refluxing event. However, it is likely that these studies are evaluating a similar population of horses, with differing levels of severity, since horses had other important features of post operative ileus, including an increase in heart rate and signs of colic. Risk factors for post operative ileus can be grouped into two important categories: those related to the degree of circulatory shock, and those related to surgery. For instance, elevated heart rate and packed cell volume in the preoperative period place horses at risk of post operative ileus, and small intestinal surgery, particularly involving strangulating obstruction, places horses at risk of post operative ileus (Holcombe et al. 2009; Torfs et al. 2009). [...]