OBSTRUCTIVE ILEUS

(Group 2)

By: Group 2
Lilis Nur Aida

(1301100002)

Genta Mahendra
(1301100003)
Kevian Septian Adi
(1301100016)
Nurul Qomariah
(1301100045)
Dyah Ayu Rachmawati
(1301100059)

TOPICS
1. Background of obstructive ileus
2. Definiton of obstructive ileus
3. Etiology of obstructive ileus
4. Pathophysiology of obstructive ileus
5. Clinic manifestation of obstructive ileus
6. Diagnostic examination of obstructive ileus
7. Medical management of obstructive ileus
8. Nursing care plan of obstructive ileus

BACKGROUND
Obstructive ileus is a mechanical blockage of the
intestine where the blockage completely closes or
disrupt the way of intestinal contents. Approximately
20% of patients come to the hospital with complaints of
acute abdomen due to obstruction of the
gastrointestinal tract, 80% occurred in intestine tenue
obstruction.
In Indonesiarecorded 7,059 cases of paralytic ileus and
obstructive without hernia who are hospitalized and
7,024 outpatients

DEFINITION OF
OBSTRUCTIVE ILEUS
Obstructive ileus is breakdown or
disappearance the passage of intestinal
contents caused by mechanical obstruction.
Barriers in the way of intestinal contents
will lead to obstructed intestinal contents
and buried in the proximal part of the
blockage so that the proximal region will
occur or dilated bowel distension.

ETIOLOGY OF OBSTRUCTIVE ILEUS

Abnormality cause of obstruction include:
1. Intestinal adhesion
Existence of fibrous tissue in the intestines were found at
birth
(congenital). However, fibrous tissue is most common
after abdominal surgery. Small intestine adhesions are
experiencing as a result of this fibrous tissue will blockage the
way of food and fluids
2. Incarcerated hernia
When it happened narrowing of the intestine can lead to
intestinal obstruction

ETIOLOGY OF OBSTRUCTIVE ILEUS

3. Tumors (primary, metastatic):
Can lead to obstruction to the entrance of food and
fluids
4. Intussusception (entry of the proximal to the distal
intestinal)
5. Volvulus (twisted intestinal).

PATHOPHYSIOLOGY OF
OBSTRUCTIVE ILEUS
Obstructive
Ileus

any
mechanical
power
affects the
intestinal
wall

passage
disturbed
intestinal
lumen

collecting the
contents of the
intestinal
lumen in the
form of gas and
liquid in the
proximal

This blockage
causes
increased
intestinal
movements
(hyper
peristalsis) as a
natural attempt

narrowing /
blockage of
the bowel
lumen

stimulation
of the
digestive
gland
hypersecreti
on

intestinal
distension of
the entire
colon at the
proximal
occlusion

CLINICAL
MANIFESTATION
OF OBSTRUCTIVE
ILEUS

1. Pain on abdomen
2. Vomit
3. Difficult to defecation
4. Feel nauseous
5. Theres blood
6. Filled with air
7. Cant flatus
8. Hyperperistaltik

DIAGNOSTIC EXAMINATION OF
OBSTRUCTIVE ILEUS
There are diagnostic examination can do:
1. X-ray on thorax: diaphragm will go high because of abdomen
distention
2. X-ray on abdomen when the patient lay on bed: to find causes
3. X-ray: to see the gas or water in abdomen
4. Laboratory examination: like a examination to the blood and
electrolit, it can show if the patient is dehydration, or maybe
loss of plasma, or theres infection
5. Radiogram examination is important to make a diagnostic

MEDICAL MANAGEMENT OF
OBSTRUCTIVE ILEUS
Basic treatment of intestinal obstruction are:
1. Treatment
2. Pharmacology
3. Paracentesis
4. Surgical actions, which include:
- Colostomy
- Stents: surgery for intestinal obstruction
depends on the cause of the obstruction. The most
common cause of obstruction such as hernia and
adhesions. The surgical action is herniotomy.

NURSING CARE PLAN OF

OBSTRUCTIVE ILEUS
Assessment
a. Identity
b. History of present illness
c. Past medical history
d. Family history

e. Activity Daily Life

a) nutrition
b) elimination
c) Activity
d) Personal Hygiene.
f. Examination
a) General condition
b) Physical Examination

Nursing Diagnosis
1. Impaired sense of comfort (pain) associated with increased
intraluminal pressure
2. Disorders of fluid and electrolyte balance associated with excess
fluid loss
3. Nutrition less than body requirements relate to nausea, vomiting
4. The risk of infection associated with peritonitis complications of
septicemia

Diagnose 1

Nursing
Intervention

1. Observation level of pain

2. Monitor the status of the abdomen every 4 hours
3. Encourage early ambulation and avoid sitting long
4. Maintain client in semi-Fowler's position
5. Maintain fasting until bowel sounds return, reduced
abdominal distension and flatus out
6. Teach relaxasi and distraction techniques
7. Collaboration: Give analgesics as an indication and
evaluation of its effectiveness

Diagnose 2
1. Monitor vital sign
2. Assess skin turgor and humidity mucous
membrane
3. Observation intake and output
4. Give extra fluids intravenously as indicated
5. Collaboration: Parenteral fluids distribution and
blood transfusion

Diagnose 3
1. Encourage restriction on activities during the
acute phase
2. Improve oral diet, either a liquid diet or low
residu diet
3. Consultation with a nutritionist
4. Collaboration: Give a drug as indicated

Diagnose 4
1. Monitor the quality and intensity of pain
2. Monitor abdominal distension
3. Observation of vital signs
4. Prepare patients for surgery if planned
5. Collaboration: Give antibiotics as indicated

CONCLUSION
1. Obstruction ileus is damage or loss of the passage of
intestinal contents caused by mechanical obstruction.
2. Clinical manifestations in ileus tenderness in the
abdomen, vomiting, constipation, abdominal
distension, Chapter blood and mucus but no feces and
flatus.
3. Diagnostic tests include: X-ray of the thorax, abdomen
X-rays, x-rays, laboratory tests), abdominal radiogram
examination is essential for diagnosis of intestinal
obstruction.