Review Note

Last Update: 09/24/2023 08:11 AM

Current Deck: Clinical Questions (General)

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You are called to review a 65 year old man who presents with 3 days of worsening abdominal pain and vomiting. His past medical history includes insulin dependent type 2 diabetes, ischaemic heart disease, 30 pack year history of smoking, and an open right hemicolectomy with ileocolic anastomosis for a hepatic flexure cancer 3 years previously. 

A CT abdomen and pelvis reveals a high-grade distal small bowel obstruction. 

1. What are the possible aetiologies? 
2. What factors would mean that this patient needs an emergency operation? 
3. How will you manage him over the next 7 days (if he doesn’t need emerg op)?
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