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Postoperative ileus — USMLE Step 3 MCQ

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

A 60-year-old man is 2 days after abdominal surgery with abdominal distension, nausea, and no flatus. He is afebrile and stable. Abdomen is tympanitic without peritoneal signs and he is receiving opioids. Which of the following is the most appropriate next step in management?

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Correct answer: D — Bowel rest, ambulation, electrolyte correction, and reduction of opioids when feasible

Postoperative ileus is managed supportively with mobilization, correction of contributors, and opioid minimization.

Reference: ACS perioperative care principles