12 Hours Of Diffuse in Surgery — 62yo Man | General Surgery | SMLE Q#781
SMLE Question #781
Surgery
General Surgery
Last updated: February 2026
A 62-year-old man presents with 12 hours of diffuse abdominal pain, distension, nausea, and repeated bilious vomiting. He has not passed stool or flatus for 24 hours. He reports a long-standing right inguinal swelling that became painful and tense earlier today but then flattened. Examination shows a distended, tympanitic abdomen with high-pitched bowel sounds and mild right groin tenderness without a visible bulge. The team is concerned about small bowel obstruction with possible ongoing closed-loop obstruction after spontaneous hernia reduction. What is the most appropriate next step in management?
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