A 80-year-old female came to emergency with obstructed incisional hernia. She had h/o incisional hernia since 50yrs and h/o hypertension and chronic constipation. Operated for obstructed incisional hernia. Hernial contents were large bowel and omentum. Bowel was healthy. Content reduced and inlay mesh applied. Just post of period patient passed motion and flatus.
On second post op day, there was no bowel sound and not passing flatus with upper abdominal distension. Paralytic ileus and gastroparesis not relieved till 6th post op day. Patient is under iv fluids, antibiotics, inj.levosulpiride, 25mg tds and bisacodyl suppository. What to do now? How to manage Paralytic ileus?
