A 68-year-old woman presents as triage level 2 with abdominal distention, vomiting, and obstipation. CT shows dilated small bowel loops with a

Question

A 68-year-old woman presents as triage level 2 with abdominal distention, vomiting, and obstipation. CT shows dilated small bowel loops with a transition point and reduced bowel-wall enhancement; lactate is 3.9 mmol/L. Which of the following is the most appropriate next step in management?

Accepted Answer

Urgent surgical consultation with antibiotics and resuscitation

Answer

Antidiarrheal medication and observation

Answer

Oral contrast challenge at home

Answer

Discharge with laxatives

Answer

Colonoscopy for decompression

Strangulated small bowel obstruction — ABEM Board MCQ

A 68-year-old woman presents as triage level 2 with abdominal distention, vomiting, and obstipation. CT shows dilated small bowel loops with a transition point and reduced bowel-wall enhancement; lactate is 3.9 mmol/L. Which of the following is the most appropriate next step in management?