2 Days Of Progressive in Surgery — 72yo Man | General Surgery | SMLE Q#17273
SMLE Question #17273
Surgery
General Surgery
Objective: OBJ-TRACH-EMERG-01
Last updated: February 2026
A 72-year-old man presents with 2 days of progressive abdominal distension, constipation, and colicky lower abdominal pain. Examination shows a markedly distended, tympanitic abdomen with mild tenderness and high-pitched bowel sounds; rectal examination reveals an empty rectal vault without blood. A plain abdominal radiograph shows a markedly dilated loop of colon arising from the pelvis with a “coffee bean” configuration and no pneumoperitoneum. What is the most appropriate initial management?
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