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Updated: Jul 1, 2025
Postoperative Ileus Murine Model
Published on: July 12, 2024
Pathophysiology and Management of Postoperative Ileus in Adults and Neonates: A Review
Sindhu Mannava1, Attie Vogler2, Troy Markel3
1Department of Surgery, Indiana University School of Medicine, Indianapolis, Indiana.
Insights
Postoperative ileus (POI) in neonates is understudied. This review examines adult and neonatal POI, highlighting the need for tailored treatments in infants due to their unique physiology.
Area of Science:
- Gastroenterology
- Neonatal Medicine
- Surgical Research
Background:
- Postoperative ileus (POI) is a common complication following abdominal surgery.
- It stems from impaired gut motility due to surgical stress, anesthesia, and opioids.
- POI leads to extended hospital stays, increased costs, and nutritional deficits.
Purpose of the Study:
- To review current understanding of POI pathophysiology and management in adults.
- To identify gaps in knowledge regarding neonatal POI.
- To explore potential applications of existing POI strategies to the neonatal population.
Main Methods:
- Comprehensive literature review of adult and neonatal studies on POI.
- Analysis of cellular pathways implicated in POI.
- Comparison of adult and neonatal gut physiology and immune responses.
Main Results:
- POI pathophysiology involves enteric neural dysfunction and inflammation.
- Neonatal gut physiology differs significantly from adults, impacting POI development.
- Limited research exists specifically on neonatal POI causes and treatments.
Conclusions:
- Understanding the distinct pathophysiology of neonatal POI is crucial.
- Further research is needed to develop targeted management strategies for infants.
- Bridging the knowledge gap in neonatal POI can improve surgical outcomes.
Abstract:
Postoperative ileus (POI) is caused by enteric neural dysfunction and inflammatory response to the stress of surgery as well as the effect of anesthetics and opioid pain medications. POI results in prolonged hospital stays, increased medical costs, and diminished enteral nutrition, rendering it a problem worth tackling. Many cellular pathways are implicated in this disease process, creating numerous opportunities for targeted management strategies. There is a gap in the literature in studies exploring neonatal POI pathophysiology and treatment options. It is well known that neonatal immune and enteric nervous systems are immature, and this results in gut physiology which is distinct from adults. Neonates undergoing abdominal surgery face similar surgical stressors and exposure to medications that cause POI in adults. In this review, we aim to summarize the existing adult and neonatal literature on POI pathophysiology and management and explore applications in the neonatal population.
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