Feasibility and Safety of an Ileus Management Protocol for Postoperative Ileus After Abdominal Surgery

"The Ileus Management Protocol (I-MAP) is a standardized algorithm for the treatment of postoperative ileus (POI) after abdominal surgery. Management decisions are based on nasogastric tube (NGT) output measured every 12 hours. Depending on output and tolerance, patients may receive:~Water-soluble contrast (Telebrix® gastro, ioxitalamic acid 300 mg/mL) administered via NGT, followed by a clamp test at 4 hours.~Diagnostic imaging (CT-scan or X-ray) if ileus persists or small bowel obstruction is suspected.~Intravenous Neostigmine® (2.5 mg diluted in 500 mL NaCl 0.9%, infused over 5 hours) as a prokinetic, only after small bowel obstruction is excluded.~The protocol is applied until resolution of POI or requirement of further intervention."