Mild Diffuse Tenderness in Surgery — 28yo Man | General Surgery | SMLE Q#16891
SMLE Question #16891
Surgery
General Surgery
Objective: OBJ-TRACH-EMERG-01
Last updated: February 2026
A 28-year-old man is on postoperative day 4 after exploratory laparotomy for perforated appendicitis. He has progressive abdominal distension, generalized discomfort, and bilious vomiting. He has passed minimal flatus and no stool for 24 hours. The abdomen is distended with mild diffuse tenderness and hypoactive bowel sounds. Upright abdominal radiograph shows diffuse gaseous distension of both small and large bowel with multiple air–fluid levels. What is the most likely diagnosis?
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