Key messages

• Intestinal dysmotility in the intensive care patient is a common problem.

• The clinical challenge is to distinguish ileus from obstruction without delay.

• The management of intestinal obstruction is surgical. Swift involvement of a general surgeon is warranted as soon as the diagnosis is suspected.

• Bowel obstruction is usually diagnosed clinically and confirmed by surgical exploration.

• Treatment of ileus is expectant. Correctable underlying causes of ileus (e.g. drugs, abdominal sepsis, and electrolyte disorders) should be addressed.

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