Puerperium: colonic pseudo-obstruction after caesarean: practice question

A OBG 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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OBG · Puerperium: colonic pseudo-obstruction after caesarean

Sample item

On day 3 after an emergency caesarean section, a woman has massive abdominal distension and mild pain. She passes occasional flatus and bowel sounds are present. X-ray shows a markedly dilated caecum and colon without a transition point. Electrolytes are normal. What is the most likely diagnosis?

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

The answer and the reasoning

A. Acute colonic pseudo-obstruction (Ogilvie syndrome)

Ogilvie syndrome is functional dilatation of the colon after surgery, and a caecal diameter beyond 9 to 12 cm risks perforation. Conservative treatment includes correcting electrolytes, stopping drugs that slow motility, and decompression. Neostigmine or colonoscopic decompression is used when conservative measures fail.

Option by option

  • A. Acute colonic pseudo-obstruction (Ogilvie syndrome) (correct)

    Correct. Colonic dilatation without a mechanical block after caesarean fits.

  • B. Mechanical small bowel obstruction from a band

    A mechanical band would show small bowel loops with a transition point and absent flatus.

  • C. Puerperal sepsis with peritonitis

    Peritonitis presents with fever, rigidity and systemic illness.

  • D. Uterine rupture

    Uterine rupture does not follow elective-type recovery in this way and would cause shock.

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 OBG questions

Questions about this OBG question

What is the answer to this OBG question?

The best answer is A, Acute colonic pseudo-obstruction (Ogilvie syndrome). Ogilvie syndrome is functional dilatation of the colon after surgery, and a caecal diameter beyond 9 to 12 cm risks perforation.

Why is "Mechanical small bowel obstruction from a band" not the answer?

A mechanical band would show small bowel loops with a transition point and absent flatus.

Why is "Puerperal sepsis with peritonitis" not the answer?

Peritonitis presents with fever, rigidity and systemic illness.

Why is "Uterine rupture" not the answer?

Uterine rupture does not follow elective-type recovery in this way and would cause shock.

What concept does this question test?

It tests Puerperium: colonic pseudo-obstruction after caesarean in OBG. Conservative treatment includes correcting electrolytes, stopping drugs that slow motility, and decompression. Neostigmine or colonoscopic decompression is used when conservative measures fail.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. 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 Puerperium: colonic pseudo-obstruction after caesarean?

Learn management algorithms as steps: PPH, eclampsia, ectopic pregnancy. Then use the flashcards and the other OBG 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.