Ileus refers to a functional disruption of the normal propulsive activity of the gastrointestinal (GI) tract, resulting in delayed passage of contents. This condition can affect any part of the GI system but most commonly impacts the small and large intestines. The condition manifests as abdominal discomfort, distension, nausea, vomiting, and the inability to pass flatus or stool, leading to complications such as bacterial overgrowth, sepsis, and multi-organ failure. Ileus often develops postoperatively or due to electrolyte imbalances, infections, or medications, especially opioids. Prompt recognition and effective management are critical to preventing severe complications like bowel perforation or ischemia [1, 2] [Ref: Algorithm 40.1].