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Strangulated small bowel obstruction — RCPSC EM MCQ

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HardGI/Abdominal emergenciesStrangulated small bowel obstructionRCPSC EM

A 73-year-old with prior laparotomy has abdominal distension, vomiting, and constant pain. CT shows closed-loop small bowel obstruction with reduced bowel wall enhancement; lactate is 4.4 mmol/L and WBC is 18 x 10^9/L. What is the most appropriate disposition?

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Correct answer: B — Emergency surgical admission for operative management

Emergency surgical admission for operative management is correct: the clues indicate Strangulated small bowel obstruction and this option addresses the immediate ED priority. The distractors delay care, target a less likely problem, or are unsafe in this physiology.

Reference: Canadian emergency surgery practice