A 60-year-old male presented to the ER complaining of abdominal distension with discomfort and obstipation for 2 days. On examination, his abdomen was diffusely distended with mild tenderness, tympanic on percussion and sluggish bowel sounds. On PR, the rectum was empty. Vital signs were stable. There was marked colonic dilatation on X-ray. Rigid sigmoidoscopy revealed gradual narrowing of the lumen at 20 cm with a normal mucosa. What is the most likely diagnosis?
سؤال مجاني 6 من 10 اليوم · اشترك وكمّل بدون حد
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الإجابة: A. Volvulus
This older man has large bowel obstruction, and at about 20 cm (sigmoid) the lumen tapers gradually with normal mucosa. That fits a twisted sigmoid (volvulus), the endoscopic match for the bird's-beak tapering seen on contrast enema. Sigmoid volvulus is a typical cause of obstruction in the elderly. Carcinoma would show an abnormal mucosal lesion (apple-core stricture). UC and acute diverticulitis would show inflamed mucosa or a septic picture.
- المصدر
- Surgical Principles - Bowel Obstruction.pdf · p. 4
INTESTINAL OBSTRUCTION.pdf · p. 5 - المحاضرة
- Bowel obstruction · General Surgery · Module D
- ظهر في
- Surgery QB (Module D) p. 42 Q46