Therapy of postoperative ileus (including peritonitis)

: In each case of postoperative ileus initial decompression of the intestine by an endoscopically placed tube is indicated (success rate 80%). With clear mechanical obstruction or diffuse peritonitis immediate relaparotomy is indicated. With prolonged gastrointestinal dilatation or paralytic ileus conservative therapy (tube-decompression, substitution of fluids and electrolytes, peristaltics, sympathicolysis with following stimulation) and close observation by an experienced surgeon is recommended. With local peritonitis (intraabdominal abscess) percutaneous puncture and drainage, sometimes just as a preliminary emergency procedure seems worthwhile.