MEDizzy - A 65-year-old man presents to the emergency room with

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Acute Abdominal Pain

A 65-year-old man presents to the emergency room with abdominal pain for the past 12 hours. The patient has nausea and has vomited once. The patient also has anorexia. On examination, a midline abdominal scar is noted and the pain is noted to be poorly localized. Plain films show some air–fluid levels but there is air and stool distally. The small bowel appears dilated. (SELECT 1 MANAGEMENT PLAN)

ExplanationB. Nausea, vomiting, anorexia, and abdominal pain associated with air–fluid levels on abdominal plain film are signs of small bowel obstruction. The presence of stool and air distal to the site of obstruction is suggestive of a partial obstruction. In some patients with a partial small bowel obstruction and previous abdominal surgery, a course of inpatient management with bowel rest, volume resuscitation, and nasogastric tube decompression may be attempted. No additional diagnostic tests are necessary at this time.