Small bowel obstruction — MCCQE Part 1 MCQ

Correct answer: B — Admit for bowel rest, nasogastric decompression, intravenous fluids and surgical assessment

Admit for bowel rest, nasogastric decompression, intravenous fluids and surgical assessment is the single best answer because the age, timing, examination findings and investigations in the vignette fit Small bowel obstruction better than the alternatives. The most tempting distractor is less appropriate because it either treats a neighbouring presentation, delays a time-critical intervention, or ignores a key discriminator in the stem. The remaining options are suboptimal because they would miss the diagnosis, use an investigation or treatment in the wrong sequence, or fail to address safety and follow-up. Canadian practice should be anchored to Canadian Association of General Surgeons guidance, with attention to acuity, safety-netting and local provincial pathways.

Reference: Canadian Association of General Surgeons guidance