Prolonged ileus after severe pelvic fracture.

The data derived from 105 severe pelvic fractures have provided guidelines for managing paralytic ileus associated with fracture. Fracture types I, II, IV, and double type III can be treated expectantly with a high degree of confidence that ileus will resolve within 2 days. Type III diametric fractures can be managed similarly for 5 days with a 70 percent (14 of 20 patients in this study) likelihood that ileus will resolve. However, should ileus in patients with diametric fractures continue longer than 5 days, parenteral nutrition should be started, since ileus will persist for an average of 2 weeks. A direct correlation between type of pelvic fracture, amount of retroperitoneal blood, loss and duration of ileus has been documented.