Intestinal obstruction: practice question

A General Surgery question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Surgery · Intestinal obstruction

Sample item

An elderly bedridden man has abdominal distension and constipation. The abdominal radiograph shows a massively dilated, inverted U-shaped (coffee bean) loop from the pelvis towards the right upper quadrant. If there are no signs of peritonitis, what is the initial treatment?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Sigmoidoscopic detorsion with rectal tube placement

Sigmoid volvulus is the commonest site of colonic volvulus in adults and shows a coffee bean sign. Without gangrene or perforation, endoscopic decompression relieves obstruction in most cases. Because recurrence is high, elective sigmoid colectomy is usually done after.

Option by option

  • A. Oral laxatives

    Laxatives are contraindicated in obstruction and risk perforation.

  • B. Barium enema in all cases with peritonitis

    Peritonitis requires emergency laparotomy and a contrast enema is contraindicated.

  • C. Immediate right hemicolectomy

    A right hemicolectomy is for caecal pathology, not the sigmoid.

  • D. Sigmoidoscopic detorsion with rectal tube placement (correct)

    Correct. Detorsion avoids emergency surgery in a frail patient, and surgery follows electively.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More General Surgery questions

Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is D, Sigmoidoscopic detorsion with rectal tube placement. Sigmoid volvulus is the commonest site of colonic volvulus in adults and shows a coffee bean sign.

Why is "Oral laxatives" not the answer?

Laxatives are contraindicated in obstruction and risk perforation.

Why is "Barium enema in all cases with peritonitis" not the answer?

Peritonitis requires emergency laparotomy and a contrast enema is contraindicated.

Why is "Immediate right hemicolectomy" not the answer?

A right hemicolectomy is for caecal pathology, not the sigmoid.

What concept does this question test?

It tests Intestinal obstruction in General Surgery. Without gangrene or perforation, endoscopic decompression relieves obstruction in most cases. Because recurrence is high, elective sigmoid colectomy is usually done after.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Intestinal obstruction?

Learn classic signs and eponyms alongside what they diagnose. Then use the flashcards and the other General Surgery questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.