Abstract
Many different factors are known to be able to cause an ileus. A 72-year-old male underwent an endovascular procedure to treat his ruptured abdominal aneurysm. He developed a mechanical ileus five days after surgery. During re-operation an enormous retroperitoneal hematoma was revealed, causing the obstruction. Radiological re-evaluation can be useful and operative exploration must be considered in case of imminent perforation and/or after unsuccessful (conservative) therapy of an ileus. One should be aware that a retroperitoneal hematoma following a ruptured abdominal aneurysm can, in rare cases, cause a large bowel obstruction and therefore may need surgical intervention.
Highlights
Many different factors are known to be able to cause an ileus
The patient was admitted to the hospital and underwent an emergency endovascular procedure to treat both the dissection and the ruptured aneurysm
Due to insufficient effect after conservative treatment a laparotomy was performed 12 days after the initial operation, during which a large retroperitoneal hematoma causing a mechanical obstruction by compressing the large bowel, was revealed
Summary
Many different factors have been identified to be able to cause an ileus Both a paralytic ileus and a mechanical ileus (i.e., bowel obstruction) are known complications after surgery [1]. The patient reported an acute onset with abdominal discomfort. His medical history consisted of total hip replacement on the left side, total knee replacement on the right side, transient ischemic attack and spinal disc herniation. Five days after the operation, he developed an ileus He reported abdominal discomfort with nausea and vomiting. His abdomen was distended with a painful right lower quadrant during palpation. Due to insufficient effect after conservative treatment a laparotomy was performed 12 days after the initial operation, during which a large retroperitoneal hematoma causing a mechanical obstruction by compressing the large bowel, was revealed.
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