J Acute Care Surg.  2017 Oct;7(2):78-82. 10.17479/jacs.2017.7.2.78.

Neostigmine Treatment of Paralytic Ileus in Critically Ill Patients

Affiliations
  • 1Division of Trauma and Surgical Critical Care, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. skhong94@amc.seoul.kr

Abstract

Paralytic ileus is a common complication in critically ill patients, and can affect all parts of the gastrointestinal tract. We report a case of paralytic ileus that improved after neostigmine administration. An 80-year-old man was transferred to the intensive care unit after a diagnosis of severe colitis due to Clostridium difficile infection while under conservative treatment for paralytic ileus . The patient's colitis resolved but the ileus did not. This prompted neostigmine administration, resulting in remarkable improvements in the abdominal physical examination and radiographic images. Bowel movements recovered, oral feeding was restarted, and the patient was transferred back to the general ward.

Keyword

Paralytic ileus; Critical illness; Neostigmine

MeSH Terms

Aged, 80 and over
Clostridium difficile
Colitis
Critical Illness*
Diagnosis
Gastrointestinal Tract
Humans
Ileus
Intensive Care Units
Intestinal Pseudo-Obstruction*
Neostigmine*
Patients' Rooms
Physical Examination
Neostigmine
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