Prolonged post-operative ileus: Experience in a Tertiary hospital in Bayelsa State, Nigeria

Background: Ileus is defined as the functional inhibition of propulsive bowel activity, irrespective of the pathogenic mechanism. Prolonged post-operative ileus (PPOI) is an absence of bowel function lasting more than 3 days after a surgical procedure. It is a common postoperative complication with multifactorial aetiology and pathophysiology which can result in increased morbidity and mortality. Early recognition and proper treatment remain crucial in managing this condition. Aim: To determine the aetiology, clinical presentation, treatment outcome and complications of patients presenting with prolonged postoperative ileus. Methods: A retrospective observational study of all patients with a diagnosis of prolonged postoperative ileus at the Niger Delta University Teaching Hospital, between January 2020 and December 2023. Data was obtained using a standardized proforma and analysis done using Statistical Package for the Social Sciences (SPSS) version 21.0 for Windows. Results: A total of 60 patients were studied, 39 males and 21 females with a male to female ratio of 1.86:1. Patients 40 years or older were more often affected. Perforated viscus and strangulated hernia were the leading diagnoses associated with prolonged postoperative ileus. The most common forms of presentation were abdominal pain, abdominal distension and anorexia. Most patients responded to conservative management. The most common complication was hypokalaemia. Mortality was 10%. Conclusion: Prolonged post-operative ileus is common in clinical practice and is associated with increased morbidity and mortality. Early recognition along with appropriate and timely treatment is essential in management.