Ileus conduent

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Inventor before : Chen Daici. Inventor before : Hu Minhui. Inventor before : Zhao Yebiao. Inventor before : Zhong Qinghua. Inventor before : Feng Shaoyong. Inventor before : Yang Zifeng.

Inventor before : Wang Hui. Inventor before : Cai Jian. Inventor before : Li Wenhui. Inventor before : Chu Lili. Inventor before : Huang Rongkang. Inventor before : Ma Tenghui. Inventor before : Wang Huaiming. A ileus pipe for intestinal arrangement can be used for the intestinal decompression, effectively alleviates the multinode small intestine of intestinal cancer peritoneum transfer and blocks, still has super-smooth and antibacterial property, and the operation is convenient, can restrain the intestinal bacterium and multiply at pipe surface field planting, prevents the intestinal bacterium and shifts.

Intestinal obstruction catheter for small intestine arrangement Technical Field. The utility model relates to a clinical medical instrument technical field, more specifically relates to the utility model relates to a when peritoneal metastasis merges small intestine multi-section to colorectal cancer and blocks, be used for the intestinal obstruction pipe that the small intestine was arranged in the operation.

Multiple segments of small intestinal obstruction are one of the main causes of death in peritoneal metastasis of intestinal cancer. Excision of small intestine, arrangement of small intestine and decompression of small intestine are important methods for treating intestinal cancer peritoneal metastasis with intestinal obstruction.

Through ilering the near-end in the art and implanting the small intestine and arranging the pipe, reach the ileocecal part through the stoma department, can avoid cutting off the small intestine by a large scale, avoid short bowel syndrome, can alleviate intestinal obstruction and can prevent to be blocked again after the small intestine is arranged, improve nutrition, prolong patient's life. Traditional anus or oral cavity ileus pipe need implant with the help of the scope under the X line perspective, and the radiation is big and drop easily, often fails because of implanting the position is unsatisfactory to multi-section small intestine obstruction, and the pipe can not be antibiotic, and the easy secondary intestinal bacterium shifts to infect, and the pipe material is rough on the hard surface partially, is difficult for implanting, also is difficult for taking out after the implantation, causes the small intestine to perforate easily.

Meanwhile, the traditional ileus catheter does not support drug and nutrient injection either. The utility model aims at overcoming above-mentioned prior art's at least one not enough, provide a ileus pipe for the small intestine is arranged, ileus pipe for the small intestine is arranged can be used for the intestinal decompression, effectively alleviates the multiunit section small intestine that the intestinal cancer peritoneum shifted and blocks, still has super-smooth and antibacterial property, and the operation is convenient, can restrain the intestinal bacterium and multiply at pipe surface field planting, prevents the intestinal bacterium and shifts.

Meanwhile, the intestinal obstruction catheter can be used for injecting medicines and nutrients. The utility model adopts the following technical scheme:. A ileus pipe for small intestine is arranged can be followed and is blocked the near-end and implant, it gets into the distal end to make mouthful near-end pass through making mouthful department through the small intestine, wherein the seal wire can be at seal wire passageway internalization, because the one end and the pipe head of seal wire are connected, the seal wire itself has certain rigidity, the pipe head motion can be controlled through the other end of control seal wire to the doctor, make the pipe head can control the luffing motion about in the intestinal, also can be forward or backward motion, conveniently pass a plurality of stages and block the position, thereby conveniently control ileus pipe arrival target location, need not to implant with the help of the scope under the X line perspective, reduce the radiation.

The through holes on the catheter head and the catheter are convenient for liquid in the intestinal tract to flow into the catheter containing cavity of the intestinal obstruction catheter from the through holes, so that the resistance of the movement of the intestinal obstruction catheter is reduced, the flow of the liquid in the intestinal tract is not influenced, and the catheter is prevented from being blocked.

The air bag valve can control the expansion or contraction of the air bag through the air bag channel, and the intestinal obstruction catheter is conveniently fixed to prevent the intestinal obstruction catheter from slipping when the air bag expands.

The antibiotic on the inner surface of the intestinal obstruction catheter can inhibit intestinal bacteria from being planted and propagated on the surface of the catheter and prevent the intestinal bacteria from shifting. The smooth coating on the outer surface of the intestinal obstruction catheter can facilitate the intestinal obstruction catheter to be smoothly inserted into small intestines for intestinal arrangement, so that the small intestines are prevented from being perforated, and the intestinal obstruction catheter can be conveniently and directly pulled out through a stoma after obstruction is relieved.

The medicine and nutrient channel is convenient for patients with special conditions, and medicines or nutrient solution can be injected into the intestinal tract from the medicine channel for auxiliary treatment. Preferably, the ileus conduit is between 3. Preferably, the balloon is located adjacent the head of the catheter, and the balloon is positioned adjacent the head of the catheter to facilitate securement of the ileus catheter upon inflation of the balloon.

Preferably, the catheter is a silicone catheter, a latex catheter or a polyurethane catheter. The silica gel catheter, the latex catheter or the polyurethane catheter is soft in texture and good in water wettability, can conform to the bent small intestine and prevents intestinal perforation.

Preferably, the catheter head is hemispherical, semi-football shaped, conical, truncated cone shaped or arrowhead shaped. The catheter head is configured in such a way that it facilitates movement of the catheter in the intestine. Preferably, the lubricious coating is a layer of vinyl pyrrolidone.

Compared with the prior art, the beneficial effects of the utility model are that:. Description of the drawings: 1. The drawings of the present invention are for illustration purposes only and are not to be construed as limiting the invention.

For a better understanding of the following embodiments, certain features of the drawings may be omitted, enlarged or reduced, and do not represent the size of an actual product; it will be understood by those skilled in the art that certain well-known structures in the drawings and descriptions thereof may be omitted.

As shown in fig. The ileus catheter for small intestine arrangement described in this embodiment 1 can be implanted from the proximal end of obstruction, and enters the distal end through the proximal end of small intestine stoma after passing through the stoma, where the guide wire 10 can move in the guide wire channel 7, because one end of the guide wire 10 is connected with the catheter head 2, the guide wire 10 itself has a certain rigidity, the doctor can control the catheter head 2 to move by controlling the other end manual control of the guide wire 10, so that the catheter head 2 can swing up and down in the intestinal tract, and also can move forward or backward, and conveniently pass through multiple stages of obstruction parts, thereby conveniently controlling the ileus catheter to reach the target position, and without implanting by means of an endoscope under X-ray fluoroscopy, and reducing radiation.

The through holes 13 on the catheter head 2 and the catheter 1 are convenient for liquid in the intestinal tract to flow into the catheter containing cavity 6 of the intestinal obstruction catheter from the through holes, so that the resistance of the movement of the intestinal obstruction catheter is reduced, the flow of the liquid in the intestinal tract is not influenced, and the catheter can be prevented from being blocked. The air bag valve 4 can control the expansion or contraction of the air bag 4 through the air bag channel 8, the air bag expands when inflated, and the air bag shrinks when deflated.

When the ileus catheter for small intestine alignment reaches the target position, the balloon is inflated, and the ileus catheter can be fixed to prevent the ileus catheter from slipping off. The antibiotic 12 on the inner surface of the intestinal obstruction catheter can inhibit intestinal bacteria from being planted and propagated on the surface of the catheter and prevent the intestinal bacteria from shifting.

The smooth coating 11 on the outer surface of the ileus catheter can facilitate the ileus catheter to be smoothly inserted into small intestines for intestinal arrangement, so as to prevent the small intestines from being perforated, and the ileus catheter can be conveniently and directly pulled out through a stoma after obstruction is relieved. The head of the catheter is arranged into a rocket head shape to facilitate the movement of the catheter in the intestinal tract. Continence rates for most patients continue to improve up to 6 to 12 months as the OBS capacity increases.

Treatment options for those with persisting severe incontinence may include periurethral collagen injection, a urethral sling, or an artificial urinary sphincter. It may take patients up to 24 months to regain nocturnal continence as the OBS capacity increases.

Analysis of the literature by Hautmann et al. Loss of nocturnal continence is due to the absence of the neurogenic feedback, the sphincter detrusor reflex, and decrease in nocturnal sphincter tone.

Multivariate analysis found that large postvoid residual volume, frequency, and amplitude of contractions of the ileal segment were independently associated with nocturnal incontinence [ 44 ]. Patients who have nocturnal enuresis are advised to void before going to bed, avoid alcohol and hypnotics in the evening, and set an alarm clock to wake up at least once at night to void.

In summary, continence following OBS construction can be optimised by the use of detubularised ileum, of sufficient length and construction technique to give a large capacity, preservation of urethral sphincter function through nerve sparing techniques, and maximising urethral length. Voiding in patients with OBS requires both the pelvic floor to relax and a simultaneous increase in intra-abdominal pressure which is best achieved in a sitting position.

Occasionally, the use of manual pressure to the suprapubic area and bending forward while sitting may facilitate voiding. Video urodynamics show that, in women, the OBS falls into the pelvic cavity resulting in mechanical obstruction due to kinking of the OBS-urethral junction [ 46 ].

Hence, it has been suggested that in female patients packing of the posterior pelvis coupled with an anterior superior fixation of the OBS might reduce the incidence of urinary retention. Other proposed techniques include sacrocolpopexy with mesh and omental packing between the vagina and bladder [ 47 ] or suturing the OBS at the dome to the rectus muscles with posterior packing of the pouch and fixing the peritoneum of the rectum to the vaginal stump [ 46 ].

All patients with suspected urinary retention should be evaluated to exclude urethra or ureteroileal anastomosis stricture. The main risk factors for urinary retention after OBS reconstruction are a large capacity OBS due to excessive bowel segment length and nonnerve sparing techniques. Patients are therefore advised to empty their OBS at regular intervals to prevent the development of an atonic pouch.

Treatment for urinary retention is intermittent self-catheterization, and all patients should be counselled about this preoperatively. Alpha blockers are unfortunately not effective [ 46 ]. Follow-up should be risk adapted and patients with high risk of recurrence such as extravesical disease, positive lymph node status, positive surgical margins, multifocal tumour, and urethral tumour should be reviewed more regularly [ 48 ].

Early follow-up 4 months is essential to recognize ureteroileal strictures. From 4—60 months oncological surveillance is the primary concern, which is normally performed using CT scans. The majority of tumour recurrences occur within two years of surgery [ 49 ]. Although most early recurrences are asymptomatic, symptoms suggesting recurrence include pain, haematuria, urinary retention, flank pain, and palpable mass [ 49 ].

In addition to routine blood test such as full blood count, renal function, and electrolyte, live function test and bone profile, bicarbonate, chloride, Vitamin B12, and folate should also be performed.

Urethral recurrence has been observed in 5. Common sites of distal recurrence include lung, liver, and bones. Table 2 describes the European Association of Urology EAU recommendation for a risk adopted surveillance protocol [ 15 ].

MRI is an alternative in patients for whom CT scans are contraindicated due to impaired renal function or contrast allergy. Patients not at high risk and with no clinical suspicion of upper tract recurrence do not routinely need upper tract imaging [ 48 ]. The ICUD-EAU Consultation in Bladder Cancer does not recommend the routine use of urinary cytology, urethral washing, and urethroscopy in asymptomatic patients, although they are routinely performed in some centres [ 48 ].

Recommended follow-up regime by European Association of Urology. Adapted from Stenzl et al. Radical cystectomy with OBS reconstruction is a challenging procedure that carries a significant risk of short and long term complications. The technique is gaining popularity and should be offered to patients in the absence of absolute contraindications whilst taking into account oncological and patient factors.

It is important to manage patient's expectations and ensure that they are committed and fully engaged during the postoperative period. Ileal OBS with freely refluxing ureteroileal anastomosis is most commonly performed and although many techniques exist, no one technique is considered superior. Robotic assisted radical cystectomy is gaining popularity, and although technically challenging intracorporeal OBS reconstruction is routinely performed in select centres.

All patients with OBS reconstruction should have regular long term follow-up for oncological surveillance and to identify complications should they arise. The authors declare that there is no conflict of interests regarding the publication of this paper. Adv Urol. Published online Nov Lamb , 2 and John D. Kelly 1 , 2. Benjamin W.

John D. Author information Article notes Copyright and License information Disclaimer. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract Radical cystectomy and orthotopic reconstruction significant morbidity and mortality despite advances in minimal invasive and robotic technology. Introduction Radical cystectomy remains the gold standard for treatment of patients with muscle invasive bladder cancer, or recurrent high grade non-muscle invasive bladder cancer.

Minimizing Morbidity and Mortality In the United States, an analysis of 35, cases from the National Cancer Database reported day and day operative mortality rates of 3. Enhanced Recovery The enhanced recovery program ERP has been shown to reduce the occurrence of adverse events and length of stay for patients undergoing abdominal surgery across a number of disciplines [ 11 ].

Table 1 Early and late complications of radical cystectomy with OBS reconstruction. Open in a separate window. Late Complications Patients undergoing OBS may continue to develop complications even up to 10 years after surgery [ 25 ]. Urinary Tract Infection The presence of leucocytes and bacteria is commonly seen in urine culture of patients with OBS. Deterioration in Renal Function There are two main factors following OBS that are thought to play a role in deterioration of patients' renal function: Hydronephrosis secondary to ureteroileal strictures.

Calculi Formation OBS calculi formation has an incidence of 0. Metabolic Complications The metabolic consequences of OBS formation are dependent on the type, position, and length of bowel used. Figure 1. Incontinence Many factors influence continence following OBS reconstruction.

Urinary Retention Voiding in patients with OBS requires both the pelvic floor to relax and a simultaneous increase in intra-abdominal pressure which is best achieved in a sitting position. Long Term Follow-Up Follow-up should be risk adapted and patients with high risk of recurrence such as extravesical disease, positive lymph node status, positive surgical margins, multifocal tumour, and urethral tumour should be reviewed more regularly [ 48 ].

Table 2 Recommended follow-up regime by European Association of Urology. Conclusion Radical cystectomy with OBS reconstruction is a challenging procedure that carries a significant risk of short and long term complications. Conflict of Interests The authors declare that there is no conflict of interests regarding the publication of this paper.

References 1. Zakaria A. Postoperative mortality and complications after radical cystectomy for bladder cancer in Quebec: a population-based analysis during the years — Canadian Urological Association Journal.

Hounsome L. Trends in operative caseload and mortality rates after radical cystectomy for bladder cancer in England for — European Urology. Stein J. Radical cystectomy in the treatment of invasive bladder cancer: long-term results in 1, patients. Journal of Clinical Oncology. Shabsigh A. Defining early morbidity of radical cystectomy for patients with bladder cancer using a standardized reporting methodology.

Hautmann R. Lessons learned from 1, neobladders: the day complication rate. The Journal of Urology. Nielsen M. Association of hospital volume with conditional day mortality after cystectomy: an analysis of the National Cancer Data Base. BJU International. Finks J. Trends in hospital volume and operative mortality for high-risk surgery. The New England Journal of Medicine. Powles T. Innovation: London Cancer—multidisciplinary approach to urological cancer. Nature Reviews Clinical Oncology.

Ghaferi A. Variation in hospital mortality associated with inpatient surgery. Kehlet H. Multimodal approach to control postoperative pathophysiology and rehabilitation. British Journal of Anaesthesia. Daneshmand S. Enhanced recovery protocol after radical cystectomy for bladder cancer.

Thorell A. Insulin resistance: a marker of surgical stress. Inman B. Routine nasogastric tubes are not required following cystectomy with urinary diversion: a comparative analysis of patients.

Stenzl A. The updated EAU guidelines on muscle-invasive and metastatic bladder cancer. Chang S. Causes of increased hospital stay after radical cystectomy in a clinical pathway setting.

Journal of Urology. Lee C. Alvimopan accelerates gastrointestinal recovery after radical cystectomy: a multicenter randomized placebo-controlled trial.

Noble E. Gum chewing reduces postoperative ileus? A systematic review and meta-analysis. International Journal of Surgery. Parekh D. Continent urinary reconstruction versus ileal conduit: a contemporary single-institution comparison of perioperative morbidity and mortality. Mattei A. To stent or not to stent perioperatively the ureteroileal anastomosis of ileal orthotopic bladder substitutes and ileal conduits?

Results of a prospective randomized trial. Surgical Atlas: the orthotopic T-pouch ileal neobladder. Cerantola Y. Guidelines for perioperative care after radical cystectomy for bladder cancer: enhanced recovery after surgery ERAS society recommendations.

Clinical Nutrition. Sun A. Venous thromboembolism following radical cystectomy: significant predictors, comparison of different anticoagulants and timing of events. Vandlac A.

Timing, incidence and risk factors for venous thromboembolism in patients undergoing radical cystectomy for malignancy: a case for extended duration pharmacological prophylaxis. Suriano F. Bacteriuria in patients with an orthotopic ileal neobladder: urinary tract infection or asymptomatic bacteriuria? Wood D. Incidence and significance of positive urine cultures in patients with an orthotopic neobladder. Studer U. Antireflux nipples or afferent tubular segments in 70 patients with ileal low pressure bladder substitutes: long-term results of a prospective randomized trial.

Skinner E. Randomized trial of studer pouch versus T-pouch orthotopic ileal neobladder in patients with bladder cancer. Kristjansson A. Renal function up to 16 years after conduit refluxing or anti-reflux anastomosis or continent urinary diversion.

Glomerular filtration rate and patency of uretero-intestinal anastomosis. British Journal of Urology. Tan W. Robot-assisted intracorporeal pyramid neobladder.

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Do not try to "patch it up. A pouch that continually leaks should be attended to by an enterostomal therapist or nurse specialist who can help you find one that fits better, If there is a great deal of itching around the stoma, this can be an allergy to the adhesive, to the special items used to protect the skin, or to overgrowth of bacteria.

Once again, a specialist in stoma care can be of help in clearing up these skin conditions. This is done gently to protect the skin around the stoma. First the appliance is emptied. Then, while one hand removes the appliance, the other hand supports the skin around the stoma. If cement has been used to adhere the appliance to the skin, the correct solvent is applied with a cotton-tip applicator to the area at the edge of the appliance; when the cement has been dissolved in that area, the loosened section of the appliance is eased from the skin.

This process is repeated as necessary. The soiled appliance is set aside. A shower, bath or sponge bath with warm water cleans the area will. The skin is washed gently, not rubbed. If mild soap is used, it must be rinsed off completely. The skin is then blotted completely dry. If the stoma continues discharging during the cleaning process, a tampon or a pill bottle the size of the stoma can catch any waste.

Many ostomates rely on some kind of commercial product to protect the skin around the stoma. These products, which come as a pliable gum either as a pre-cut ring or as a sheet , paste, powder, spray, creme, or liquid, protect the skin right up to the stoma.

Directions for each product will be on the container. If there is an opening at the bottom of the appliance, it is closed. If cement is used, a thin coat is applied to both the appliance faceplate and to a circle of skin around the stoma slightly larger than the area the faceplate will cover. The cement is allowed to dry for several minutes before the appliance is attached.

In the case of a two-piece appliance, the separate faceplate is adhered to the skin; the pouch is then secured to the faceplate. A porous tape can be used-picture-frame fashion-around the edges of the appliance faceplate. Some ostomates use a belt, which is put on around the hips at the level of the stoma, loosely enough so that two fingers can be slipped between belt and skin.

For most people, an ostomy is a life-saving surgery which allows one to resume the lifestyle to which he or she is accustomed. Over a million people are wearing their pouches comfortably, eating the foods they like, engaging in all kinds of activities, and enjoying life.

The United Ostomy Association is a nationwide group of people who have had ostomy surgery. They meet regularly in every major city of the United States. After your surgery, you may want to meet people who have had the same type of surgery. Along with your doctor and enterostomal therapist, the United Ostomy Association can be a source of invaluable aid in helping you adjust to your ostomy and master some of the concerns which you are bound to have.

Total parenteral nutrition TPN is recommended if the patient is unable to tolerate adequate oral intake after seven days. Decreasing opiate use and transitioning to a multimodal pain regimen has benefits, as does early ambulation. In the setting of postoperative ileus, the best treatment is prevention.

Enhanced recovery protocols, regional anesthesia, opioid-sparing analgesics, and laparoscopy have all shown improvement in the number of postoperative ileus cases. The evaluation of an ileus needs to exclude other more concerning diagnoses such as small bowel obstruction, intra-abdominal abscess, or perforation. Some of these may require some type of intervention, and it is important to distinguish them. The most important diagnosis to distinguish from an ileus is an obstruction.

Patients with a postoperative obstruction often have an initial return of bowel function and oral intake with subsequent nausea, vomiting, abdominal distention, and pain, whereas an ileus patient usually has no return of bowel function or oral intake.

The use of small bowel follow-through with gastrografin or water-soluble contrast is becoming increasingly useful for small bowel obstructions and can help to further distinguish obstruction from an ileus.

Gastrografin has been noted to therapeutically treat adhesive small bowel obstructions. The overall prognosis from an ileus is good with patients eventually recovering, but the exact number of days until the return of bowel function is uncertain. Longer hospital stays increase the risk of nosocomial infections, and a prolonged ileus may lead to the need for TPN, which has its own risks and benefits.

Most of the complications come from the prolonged hospital stay and the possibility for subsequent procedures for a prolonged ileus peripheral inserted central catheter line, TPN, NG tube placement. From a surgical perspective, it is paramount to encourage and educate patients on the benefits and risks of surgery, including the possibility of an ileus. Encouraging ambulation, enhanced recovery after surgery ERAS protocols, and educating the patient on their importance and benefits should improve patient understanding and compliance.

Once diagnosed, treatment is supportive IV fluids, NG decompression with the management of precipitating factors opiates, sepsis. At times this can be difficult and often requires all aspects of the healthcare system to participate in its prevention. You are not required to obtain permission to distribute this article, provided that you credit the author and journal. Turn recording back on. Help Accessibility Careers. StatPearls [Internet].

Search term. Ileus Elsworth C. Affiliations 1 Western Reserve Hospital. Continuing Education Activity Ileus refers to the intolerance of oral intake due to inhibition of the gastrointestinal propulsion without signs of mechanical obstruction. Introduction Ileus, also known as paralytic ileus or functional ileus, occurs when there is a non-mechanical decrease or stoppage of the flow of intestinal contents.

Etiology The cause of ileus has yet to be clearly defined. Epidemiology The incidence of ileus varies greatly, often dependent upon the type of surgery, the amount of bowel manipulation, and preoperative comorbidities.

Pathophysiology The exact mechanism and cause of ileus are incompletely understood due to the complexity and numerous systems and factors involved. History and Physical The patient will present with abdominal distension and bloating that is often a slow onset as opposed to the sudden onset usually seen with mechanical bowel obstruction.

Evaluation Plain abdominal films are usually the first diagnostic imaging obtained. Differential Diagnosis The evaluation of an ileus needs to exclude other more concerning diagnoses such as small bowel obstruction, intra-abdominal abscess, or perforation. Prognosis The overall prognosis from an ileus is good with patients eventually recovering, but the exact number of days until the return of bowel function is uncertain. Complications Most of the complications come from the prolonged hospital stay and the possibility for subsequent procedures for a prolonged ileus peripheral inserted central catheter line, TPN, NG tube placement.

Deterrence and Patient Education From a surgical perspective, it is paramount to encourage and educate patients on the benefits and risks of surgery, including the possibility of an ileus. Level 1- post-op analgesia with epidural catheter [2] [20]. Level 1 - post-op gum-chewing is beneficial [2] [20].

Level 1 - prokinetic drugs neostigmine, metoclopramide, erythromycin or laxatives are not effective once ileus is diagnosed [2] [26].

Level 2 - adding peripheral opioid antagonist naloxone [27]. Review Questions Access free multiple choice questions on this topic.

Comment on this article. References 1. Postoperative ileus: Pathophysiology, incidence, and prevention. J Visc Surg. Ileus in Adults. Dtsch Arztebl Int. Economic burden of postoperative ileus associated with colectomy in the United States. J Manag Care Pharm. Postoperative ileus. Dig Dis Sci. Holte K, Kehlet H. Postoperative ileus: a preventable event. Br J Surg. Prolonged postoperative ileus-definition, risk factors, and predictors after surgery.

World J Surg. A model to investigate postoperative ileus with strain gauge transducers in awake rats. J Surg Res. Effects of halothane, enflurane, and nitrous oxide on colon motility. Identifying risk factors for potentially avoidable complications following radical cystectomy. J Urol. Risk factors for prolonged ileus following colon surgery. Surg Endosc. Postoperative paralytic ileus after major oncological procedures in the enhanced recovery after surgery era: A population based analysis.

Surg Oncol. Patterns of gastrointestinal recovery after bowel resection and total abdominal hysterectomy: pooled results from the placebo arms of alvimopan phase III North American clinical trials. J Am Coll Surg. Immune mediators of postoperative ileus. Langenbecks Arch Surg. Zentralbl Chir. Postoperative ileus: in search of an international consensus on definition, diagnosis, and treatment. CT of small-bowel obstruction: value in establishing the diagnosis and determining the degree and cause.

Distinction between postoperative ileus and mechanical small-bowel obstruction: value of CT compared with clinical and other radiographic findings. Comparative evaluation of plain films, ultrasound and CT in the diagnosis of intestinal obstruction. Acta Radiol. Chewing gum and postoperative ileus in adults: a systematic literature review and meta-analysis. Int J Surg.

Chewing gum for postoperative recovery of gastrointestinal function.