Diagnosis and treatment of acute abdomen with main clinical features of paralytic ileus: a report of 29 cases 　YUAN Chen-xi,SUN Bei,JIANG Hong-chi,et al. Department of General Surgery, the First Affiliated Hospital of Harbin Medical University,Harbin 150001,China. Corrsponding author：SUN Bei, E-mail：sunbei70@tom.com Abstract Objective To summarize the experience of the diagnosis and treatment of acute abdomen with main clinical features of paralytic ileus. Methods Clinical data of 29 cases of acute abdomen with main clinical features of paralytic ileus admitted in the First Clinical College of Harbin Medical University from January 2005 to May 2008 were analyzed retrospectively. Results 29 cases included:12 cases of gangrenous appendicitis perforation,3 cases of perforation of gallbladder,2 cases of liver abscess, 5 cases of gastric and duodenum perforation,2 cases of jejunotyphoid perforation,1 case of ascariasis,2 cases of perforation of colon and 2 cases of acute ileus of blood supplying disorder. 27 cases were cured（93.1%）and 2 cases died (6.9%). Conclusion It is difficult to confirm the etiological diagnosis of acute abdomen with main clinical features of paralytic ileus before surgery. Exploratory laparotomy should be required as soon as possible except for the factors of reflex, metabolism and medicine.