DrVirgo
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18. A 90 year old nursing home patient with advanced dementia has 2 days of vomiting and obstipation. An abdominal x-ray film shows a masively dilated colon without pneumoperitoneum. His temp is 38.1 (100F), BP is 126/82, Pulse 11/min. His abdomen is distended and diffusely tender, but there is no rebound tenderness. Which of the following is the most likelsy diagnosis?
A. Cecal volvulus
B. Diverticular disease
C. Perforated Ulcer
D. Sigmoid colon carcinoma
E. Small bowel adhesion
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| yasmeen
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B
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| DrVirgo
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Correct answer is D...
Anyone want to explain why?
Obstipation means there is obstruction like a mass... cancer..
But WHY not Small bowel adhesion... How would that present?
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| foco
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Small bowel adhesion will not cause a masively dilated colon, you probably will find air fluid levels in the x ray film.
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