While the diagnosis of ileus due to strangulated hernia is usually made almost at a glance, there are frequently well developed cases of ileus from bands and kinks, intussusception, volvulus and mesenteric thrombosis which are not easy to recognize in their early stages. The classic signs of abdominal pain, nausea and vomiting, tympany and stoppage of the bowels are frequently lacking, and the medical attendant must make an early decision whether or not laparotomy should be performed.
There frequently is no pathogonomic sign to aid in the diagnosis, and this is especially true of that form of adynamic ileus due to mesenteric thrombosis. In this condition, abdominal distention is the only sign during the early stages. The patient did not complain of pain, because of the absence of the violent peristaltic assaults on the obstructing element, so strikingly demonstrated when the muscular waves are suddenly arrested at the site of