Ileus in Acute Pancreatitis Correlates with Severity of Pancreatitis, Not Volume of Fluid Resuscitation or Opioid Use: Observations from Mid-West Cohort

The recovery of gastrointestinal functions is an important determinant of course of acute pancreatitis and the timing of hospital discharge. Here, we evaluated association between fluid resuscitation volume and opioid use with clinically significant ileus development in patients with acute pancreatitis. Consecutive adults admitted with acute pancreatitis between January 2014 and December 2019 to our academic and two community hospital were included. The Bedside Index for Severe Acute Pancreatitis (BISAP) and systemic inflammatory response syndrome (SIRS) were used to predict severity of pancreatitis based on their readily availability. Severity of pancreatitis was determined based on the Revised Atlanta classification. Fluid resuscitation volume and opioid use were collected as administered on day 1 and day 2.Clinically significant ileus was determined based on treating physician’s assessment. Forty-nine (11%) of 441 unique patients included in the study developed clinically significant ileus. Demographics of patients with or without ileus were similar between the two groups. On univariate analysis, the presence of SIRS syndrome ( 3 BISAP score ( p