Colorectal surgery: large bowel 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 · Colorectal surgery: large bowel obstruction

Sample item

An older patient has progressive abdominal distension, colicky pain, obstipation, and a markedly dilated colon proximal to an obstructing sigmoid lesion. Which complication becomes increasingly likely if the ileocecal valve is competent?

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

The answer and the reasoning

B. Cecal perforation

With a competent ileocecal valve, a distal large-bowel obstruction forms a closed loop and the cecum is at greatest risk of ischemia and perforation because of its large radius. This requires urgent surgical assessment.

Option by option

  • A. Gastric volvulus

    Gastric volvulus is a separate upper gastrointestinal rotation problem.

  • B. Cecal perforation (correct)

    Correct. Closed-loop colonic distension places the cecum at risk of perforation.

  • C. Acute appendicitis

    Appendicitis does not result from sigmoid obstruction in this fashion.

  • D. Splenic rupture

    Splenic rupture is usually traumatic or related to splenic pathology.

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 B, Cecal perforation. With a competent ileocecal valve, a distal large-bowel obstruction forms a closed loop and the cecum is at greatest risk of ischemia and perforation because of its large radius.

Why is "Gastric volvulus" not the answer?

Gastric volvulus is a separate upper gastrointestinal rotation problem.

Why is "Acute appendicitis" not the answer?

Appendicitis does not result from sigmoid obstruction in this fashion.

Why is "Splenic rupture" not the answer?

Splenic rupture is usually traumatic or related to splenic pathology.

What concept does this question test?

It tests Colorectal surgery: large bowel obstruction in General Surgery. This requires urgent surgical assessment.

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 Colorectal surgery: large bowel 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.