Related Experiment Videos
Paralytic ileus, a serious complication in acute diarrhoea disease among infants in developing countries
A Murtaza1, S R Khan, K S Butt
1Department of Paediatrics, King Edward Medical College Lahore Pakistan.
Insights
Antimotility drugs increase the risk of paralytic ileus in infants with acute diarrhea. While hypokalemia may play a minor role, it is not a primary cause of this serious complication.
Area of Science:
- Pediatrics
- Gastroenterology
- Clinical Medicine
Background:
- Intestinal hypomotility is a frequent complication in infants suffering from acute diarrheal disease.
- Paralytic ileus, a severe form of intestinal hypomotility, affects 12% of infants admitted with acute diarrhea.
Purpose of the Study:
- To investigate the factors contributing to the development of paralytic ileus in infants with acute diarrhea.
- To compare infants who developed ileus with a control group who did not.
Main Methods:
- A comparative study involving 30 infants with paralytic ileus (group A) and 30 age-matched infants with acute diarrhea but without ileus (group B).
- Analysis of medication use, specifically antimotility drugs, and serum potassium levels (serum-K) in both groups.
Main Results:
- Antimotility drug use was significantly higher in infants who developed paralytic ileus (group A).
- While overall serum-K levels did not differ significantly, a higher proportion of infants in group A had low serum-K (< 3 mmol/l) compared to group B.
- The mortality rate in infants with ileus treated with decompression and total parenteral nutrition was 25%.
Conclusions:
- The use of antimotility drugs is a significant predisposing factor for paralytic ileus in infants with acute diarrhea.
- Hypokalemia may be a contributing factor in some cases but is not a prerequisite for developing ileus.
Abstract:
Intestinal hypomotility is a common late complication in infants with acute diarrhoeal disease in pakistan. Among the infants admitted to our gastrointestinal unit with a history of acute diarrhoea, 35% developed abdominal distension and 12% developed the full clinical picture of paralytic ileus. The infants with ileus were treated with decompression and total parenteral nutrition; in this group the mortality rate was 25%. We compared 30 infants who developed ileus (group A) with an age-matched control group of infants (group B) who were admitted because of acute diarrhoea but did not develope ileus. The use of antimotility drugs was significantly more frequent in group A. Serum-K was not different in in group A (3.92 +/- 0.22 mmol/l) and group B (4.32 +/- 0.18 mmol/1). However, there were more patients who had serum-K below 3 mmol/l in group A (8/30) than in group B (5/30). We conclude that the use of antimotility drugs predisposes to the development of ileus in infants with acute diarrhoea. Hypokalemia may contribute to ileus in a few cases but is generally not a prerequisite.