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Postoperative ileus — USMLE Step 3 MCQ

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ModerateSurgery (post-operative, follow-up)Postoperative ileusUSMLE Step 3

A 68-year-old man is 2 days after small bowel resection. He has abdominal distention, nausea, and no flatus. He is afebrile and hemodynamically stable. Abdomen is mildly distended without peritoneal signs. Radiograph shows diffuse bowel gas without transition point. Which of the following is the most appropriate next step in management?

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Correct answer: B — Supportive care with ambulation, electrolyte correction, and limiting opioids

Early postoperative ileus is managed supportively; mechanical obstruction is suggested by a transition point or worsening focal findings.

Reference: ACS Surgery Principles