ASGE Annual GI Advanced Practice Provider Course (Virtual) - Onboarding (Day One) | March 2024-Radiology Studies Case 4 Colonic Ileus

Pdf Summary

A 68-year-old male presents with abdominal distention and no bowel movements for three days following a right hip replacement surgery. Immobile and on IV morphine, he is found to be hypokalemic. Abdominal X-rays and a CT scan reveal colonic pseudo-obstruction (ileus). Likely causes include post-op hip replacement, morphine use, and hypokalemia. Clinical manifestations include abdominal distension, pain, N/V, constipation, and paradoxical diarrhea. Management involves conservative measures initially, addressing underlying causes, and monitoring for complications. Neostigmine may be used for cecal dilation over 12 cm. Becoming proficient in interpreting imaging studies in colonic pseudo-obstruction involves developing interest, seeking mentorship, regular practice, and collaboration with radiologists. Understanding normal colon characteristics and reviewing imaging studies are key. By investing time in learning the language of radiology and disease states, healthcare providers can improve patient care.

Asset Subtitle

Janelle DeFilippis, APN-BC and Joseph Vicari, MD, MBA, FASGE

Keywords

abdominal distention

bowel movements

colonic pseudo-obstruction

hip replacement surgery

morphine use

hypokalemia

neostigmine

cecal dilation

imaging studies

patient care