

An 82-year-old female nursing home resident is admitted with massive abdominal distension and constant abdominal pain with diffuse tenderness. Abdominal x-ray shows a massively distended loop of colon with a characteristic “bent inner tube” appearance. The management of this patient should include:
Urgent laparotomy because of the massive colon distension
An attempt at endoscopic decompression with a flexible sigmoidoscope
Elective laparotomy and sigmoid resection should follow if endoscopic decompression is successful
If at urgent laparotomy resected bowel is present, colon resection with primary anastomosis is in order
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Gastroenterology MCQs
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