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Postoperative ileus — USMLE Step 3 MCQ

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

A 62-year-old man is 2 days after open colectomy. He has abdominal distention, nausea, and no flatus. He is afebrile and hemodynamically stable. Abdomen is mildly tympanitic without peritoneal signs. Radiograph shows diffuse bowel gas without a transition point. Which of the following is the most likely diagnosis?

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Correct answer: D — Postoperative ileus

Early postoperative diffuse bowel dilation without transition point or sepsis is typical of ileus.

Reference: ACS/SAGES perioperative care principles and standard surgical management guidance: https://www.facs.org/