Patient case: Ileus
A 63-year-old male presents to the hospital with a 3-day history of abdominal bloating, nausea, and inability to pass stool or gas. He underwent a right hemicolectomy for colon cancer 5 days prior and initially had an uneventful postoperative course. However, over the past few days, he developed worsening abdominal distension and discomfort.
On physical examination, the patient has a distended, tympanic abdomen with diffuse tenderness but no signs of peritonitis. Bowel sounds are absent. His vital signs are stable, and laboratory results are within normal limits, except for mild dehydration. An abdominal X-ray reveals dilated loops of bowel with air-fluid levels, consistent with postoperative ileus.
The patient is diagnosed with postoperative ileus, likely due to the recent abdominal surgery. He is managed conservatively with bowel rest, intravenous fluids, electrolyte correction, and nasogastric decompression. Over the next few days, his symptoms improve, bowel function gradually returns, and he resumes a regular diet before being discharged in stable condition.
a). Severe abdominal pain and fever
b). Abdominal bloating, nausea, and inability to pass stool or gas
c). Diarrhea and dehydration
d). Jaundice and pruritus
a). Laparoscopic cholecystectomy
b). Appendectomy
c). Right hemicolectomy
d). Gastric bypass surgery
a). Abdominal ultrasound
b). CT scan of the abdomen
c). Abdominal X-ray
d). MRI of the abdomen
a). Immediate surgical intervention
b). Oral laxatives and diet modification
c). Bowel rest, intravenous fluids, and nasogastric decompression
d). Administration of antibiotics
