MRCS PART A · APPLIED SURGICAL SCIENCE

Bowel obstruction & acute abdomen

Localise the problem. Assess viability. Reassess the plan.

Examination practice · 6 fictional adult patients · session-only progress · no patient information

Choose a patient

Patient 1 / 60 completed

A transition point after previous surgery

A 58-year-old with a previous open hysterectomy has colicky pain, vomiting and abdominal distension. Select findings before choosing between a monitored non-operative trial and urgent intervention.

1. Choose the information you need

Only one answer opens at a time. Questions do not alter the patient's facts. In a real emergency, assessment and escalation run together.

2. Which next action best fits the available evidence?A. Immediate laparotomy solely because CT shows a transition pointB. Discharge because some stool passed earlierC. Start a closely monitored surgical non-operative trial with bowel rest, decompression as indicated, fluid/electrolyte correction and explicit review triggersD. Treat as constipation with oral laxativesE. Wait without active assessment until lactate rises

Sources and scope

Guidance checked. Independent MRCS practice, not official exam material or a bedside protocol. Verify current guidance and local emergency procedures. Doses and techniques not specified here need competent clinical prescribing and assessment.