IMGUSMLEStep1

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Apr 10, 2010
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Surgical Recall says that the differential diagnosis of paralytic ileus includes retroperitoneal hemorrhage (page 288). I've tried looking up the reason behind this association but have not found anything. Does anyone know why retroperitoneal hemorrhage can lead to paralytic ileus? TIA
 

S4surgery

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1- peritoneal irritation from the blood +++ sympathetic outflow (thoracolumbar) will not be disrupted by retro-peritoneal blood

2- parasympathetic lumbosacral outflow is abolished by blood disrupting the fibers

3- please not that intrinsic gut motility is preserved- still intact but over regulated by the sympathetic tone
 

SLUser11

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Surgical Recall says that the differential diagnosis of paralytic ileus includes retroperitoneal hemorrhage (page 288). I've tried looking up the reason behind this association but have not found anything. Does anyone know why retroperitoneal hemorrhage can lead to paralytic ileus? TIA
Any stress on the body can cause an ileus. UTI, trauma, retroperitoneal hemorrhage (or any other hemorrhage for that reason). Some people get an ileus if you open a pepsi can too loudly in their hospital room. It all has to do with the parasympathetic tone.

I'm getting an ileus from this thread. But, luckily I have some sugar-free chewing gum in my white coat....
 
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JackADeli

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Aug 28, 2008
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Any stress on the body can cause an ileus. UTI, trauma, retroperitoneal hemorrhage (or any other hemorrhage for that reason). Some people get an ileus if you open a pepsi can too loudly in their hospital room. It all has to do with the parasympathetic tone...
I guess a key point that should not be overlooked.... Patients generally do not present with a paralytic ileus secondary to retro-bleed. Rather, they present with retro-bleed, get admitted, get narcotics and......
 
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