Surgical intervention is not routinely recommended for the management of ileus. However, patients with prolonged ileus, radiologic or clinical findings indicating development of ileus complication, such as intestinal perforation, strangulation or necrosis and worsening of clinical or laboratory conditions of patients may require urgent surgical intervention to identify and alleviate complications of ileus.

• Surgical intervention is not routinely recommended for the management of ileus. However, the following may require urgent surgical intervention:^[1]
  • Prolonged ileus
  • Signs of intestinal perforation, peritonitis or strangulation (such as rigidity, guarding and rebound tenderness)
  • Imaging findings that suggest intestinal perforation, strangulation or necrosis
  • Deterioration of clinical or laboratory conditions of patients
• In contrast to older studies, new investigations show that there is no certain time period recommended for the conservative management. Although more than 72 hours of conservative management is related to higher rate of surgical intervention. ^[2]

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