Paralytic Ileus, a Serious Complication in Acute Diarrhoeal Disease among Infants in Developing Countries

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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 develop ileus. The use of antimotility drugs was significantly more frequent in group A. Serum-K was not different in group A (3.92 .+-. 0.22 mmol/l) and group B (4.32 .+-. 0.18 mmol/l). 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.

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