A 60-year-old male presents 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 would be the best initial treatment?
سؤال مجاني 10 من 10 اليوم · اشترك وكمّل بدون حد
اعرض الإجابة
الإجابة والشرح
ادخل لحسابك عشان نحفظ إجاباتك ونوريك أخطاءك.
الإجابة: A. Colonoscopy and rectal tube
Obstipation, a hugely dilated colon, an empty rectum and smooth narrowing at about 20 cm with normal mucosa mean sigmoid volvulus. In a stable patient with no peritonitis, the first step is endoscopic decompression with a rectal tube, followed later by elective sigmoid colectomy.
- Laparotomy and resection are kept for gangrene, perforation or failed decompression.
- Transverse colostomy and cecostomy are not first-line treatments for volvulus.
- المصدر
- INTESTINAL OBSTRUCTION.pdf · p. 25
Bowel obstruction - Afnan.pdf · p. 35 - المحاضرة
- Bowel obstruction · General Surgery · Module D
- ظهر في
- Surgery QB (Module D) p. 45 Q57