Intestinal obstruction: adhesive 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: adhesive obstruction

Sample item

A 45-year-old with a prior laparotomy has colicky pain, vomiting and distension. He has no fever, the abdomen is soft, and CT shows a transition point without ischaemia. What is the initial management?

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

The answer and the reasoning

B. Nil by mouth, nasogastric decompression and intravenous fluids

Most adhesive small bowel obstructions settle with drip and suction, and water-soluble contrast can be both diagnostic and therapeutic. Signs of strangulation such as peritonism, fever, tachycardia or raised lactate call for urgent surgery. Electrolytes must be corrected during decompression.

Option by option

  • A. Barium enema

    Barium enema does not help small bowel obstruction.

  • B. Nil by mouth, nasogastric decompression and intravenous fluids (correct)

    Correct. Conservative treatment suits uncomplicated adhesive obstruction.

  • C. Oral laxatives

    Laxatives worsen pain and risk perforation in mechanical obstruction.

  • D. Immediate laparotomy

    Surgery is needed only for strangulation or failure of conservative therapy.

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, Nil by mouth, nasogastric decompression and intravenous fluids. Most adhesive small bowel obstructions settle with drip and suction, and water-soluble contrast can be both diagnostic and therapeutic.

Why is "Barium enema" not the answer?

Barium enema does not help small bowel obstruction.

Why is "Oral laxatives" not the answer?

Laxatives worsen pain and risk perforation in mechanical obstruction.

Why is "Immediate laparotomy" not the answer?

Surgery is needed only for strangulation or failure of conservative therapy.

What concept does this question test?

It tests Intestinal obstruction: adhesive obstruction in General Surgery. Signs of strangulation such as peritonism, fever, tachycardia or raised lactate call for urgent surgery. Electrolytes must be corrected during decompression.

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: adhesive 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.