Intestinal obstruction: caecal volvulus: 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.

Try it

General Surgery · Intestinal obstruction: caecal volvulus

Sample item

A 35-year-old woman has small bowel obstruction. Abdominal film shows a comma-shaped dilated loop in the left upper quadrant with a displaced caecal pole. Colonoscopic decompression is unlikely to succeed. What is the preferred treatment?

AColonoscopic detorsion alone as definitive careBTotal colectomyCSurgical detorsion with right hemicolectomyDSigmoid colectomy

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

The answer and the reasoning

C. Surgical detorsion with right hemicolectomy

Caecal volvulus involves twisting of a mobile caecum and ascending colon and often affects younger patients than sigmoid volvulus. Endoscopic reduction rarely works and carries a high recurrence, so the standard is surgery. Right hemicolectomy resects the mobile segment and any non-viable bowel.

Option by option

A. Colonoscopic detorsion alone as definitive care
Colonoscopy is seldom effective and is not definitive.
B. Total colectomy
Total colectomy is excessive for a localised problem.
C. Surgical detorsion with right hemicolectomy (correct)
Correct. Resection is preferred because of the high recurrence and risk of ischaemia.
D. Sigmoid colectomy
The sigmoid is not involved.

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.

Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is C, Surgical detorsion with right hemicolectomy. Caecal volvulus involves twisting of a mobile caecum and ascending colon and often affects younger patients than sigmoid volvulus.

Why is "Colonoscopic detorsion alone as definitive care" not the answer?

Colonoscopy is seldom effective and is not definitive.

Why is "Total colectomy" not the answer?

Total colectomy is excessive for a localised problem.

Why is "Sigmoid colectomy" not the answer?

The sigmoid is not involved.

What concept does this question test?

It tests Intestinal obstruction: caecal volvulus in General Surgery. Endoscopic reduction rarely works and carries a high recurrence, so the standard is surgery. Right hemicolectomy resects the mobile segment and any non-viable bowel.

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 Intestinal obstruction: caecal volvulus?

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.