Paediatric Imaging

Adynamic ileus

(also called paralytic ileus), condition in which bowel peristalsis ceases, with failure of onward propulsion of intestinal content. This is most frequent following abdominal surgery but can occur with septicaemia and metabolic disturbance. Clinically, there is abdominal distension, increased nasogastric aspirates and a paucity of bowel sounds.

On radiographic examination there are distended loops of bowel with long fluid levels as compared with the shorter ladder-like pattern in obstruction. On ultrasound there is diminished or absent peristalsis, fluid-filled bowel loops and often some free fluid in the abdomen. Distinguishing ileus from obstruction is usually clinical but in difficult cases ultrasound can be helpful as sluggish or absent bowel movement is visible in ileus. See bowel obstruction

HC