Gastrointestinal System

{"ops":[{"insert":"Diagnosis and reasoning"},{"insert":"\n","attributes":{"header":1}},{"insert":"The elderly patient with an acute abdomen is not an uncommon presentation in emergency medicine; it is also one of the most concerning, as almost half of such individuals require admission, and between one-fifth to one-third, immediate surgery.\n\nIn this specific case, note the colicky nature of the pain, associated vomiting, and reduction in bowel movements; when combined with the physical findings of abdominal distension, hyperresonance, and exaggerated bowel sounds, this is strongly suspicious of acute bowel obstruction.\n\nUrgent abdominal radiography confirms this by revealing multiple dilated loops of small bowel, with air-fluid levels forming a stepladder pattern; these findings are virtually pathognomonic for small bowel obstruction.\n\n"}]}

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