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A 90 year old female teetotal exsmoker was admitted with a two day history of central abdominal pain. She was nauseated and had not opened her bowels for the past two days. She had a history of laparoscopic cholecystectomy and oesophageal stent insertion for a benign oesophageal stricture secondary to acid reflux. She was taking fexonidine, valdecoxib, ferrous sulphate, cocodamol, and lansoprazole.
On examination, vital signs were normal. She had a tender and distended abdomen. Bowel sounds were present. She had a mildly raised urea level of 10.4 mmol/l. Her renal and liver biochemistry profiles were otherwise unremarkable. Full blood count was normal. Figure 1 shows her abdominal radiograph on admission.
How would you manage the patient?
See page 1584 for answer
This case is submitted by:
Robin Spiller, editor
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