[Surgical treatment of ileus. Differential diagnosis and therapeutic results]

Intestinal obstruction and ileus continue to represent a surgical challenge, regarding diagnosis and treatment. The decision when to operate is often difficult and should be based primarily on the clinical impression, although modern diagnostic tests are very helpful. Additionally, it is crucial to choose an operation that the patient can tolerate, as the spectrum of surgical interventions ranges from the taking-down of a single adhesion, that may be done laparoscopically, to sophisticated lysis of the intestine in patients with metastatic cancer in the peritoneal cavity, and simple diversion to extensive resections. These aspects are highly relevant, as good outcome can only be expected when the operation is performed correctly and optimal timing and appropriate choice of procedure are ensured.