5 Days Of Progressive in Medicine / Internal Medicine — 52yo Woman | Gastroenterology | SMLE Q#16561

SMLE Question #16561

Medicine / Internal Medicine Gastroenterology

Objective: OBJ-433

Last updated: February 2026
A 52-year-old woman taking antipsychotic medication presents with 5 days of progressive abdominal distension and constipation. She has no vomiting. Examination shows a markedly distended, soft abdomen without guarding or rebound tenderness. Abdominal radiography shows colonic dilatation up to 10 cm, most prominent in the caecum and proximal colon, with no evidence of a mechanical obstruction. What is the most appropriate next step in management?

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