bobby
Forum Guru
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An 81-year-old man with Alzheimer disease who lives in a nursing home undergoes surgery for a fractured femoral neck. On the 5th postoperative day, it is noted that his abdomen is grossly distended and tense, but not tender. He has occasional bowel sounds. The rectal vault is empty on digital examination, and there is no evidence of occult blood. X-ray films show a few distended loops of small bowel and a very distended colon. The cecum measures 9 cm in diameter, and the gas pattern of distention extends throughout the entire large bowel, including the sigmoid and rectum. No stool is seen in the films. Other than the abdominal distention, and the ravages of his mental disease, he does not appear to be ill. Vital signs are normal for his age. Which of the following is the most likely diagnosis?
A. Fecal impaction
B. Mechanical intestinal obstruction
C. Ogilvie syndrome
D. Paralytic ileus
E. Volvulus of the sigmoid colon
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| nisha
lil monkey
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C. Ogilvie syndrome..i guess this because its common in bed bound nursing home patients, and recent orthopedic surgery
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| SDK
Forum Fanatic
Topics: 537
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C...Ogilvie syndrome.....acute colonic pseudo.obstruction
Also in other surgical procedures..cardiac,abdominal,renal,neurological surgeries.
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| chemamr
Moderator and PGY1
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i agree with ogilvie Sx. 
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| bobby
Forum Guru
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correct
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| vikram25
Forum Newbie
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it's c
faecal impaction ruled out as rectum is empty on p/r
mechanical obstruction not present as bowel sounds should be raised
paralytic ileus they should have been absent
sigmoid volvulus if present whole of small gutwould also have been dilated
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| tamar
Forum Senior
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Posts: 105
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C.
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