Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with acute onset of severe, colicky abdominal pain, predominantly in the periumbilical and right lower quadrant regions. Associated with progressive abdominal distension, nausea, and bilious vomiting. History of obstipation and failure to pass flatus for [X] hours. No prior abdominal surgeries noted. Symptoms consistent with mechanical bowel obstruction secondary to cecal volvulus.
Clinical Examination Findings
Abdomen is markedly distended and tympanitic to percussion. Tenderness noted on palpation, localized to the right lower quadrant; no signs of localized peritonitis or rebound tenderness at this time. Bowel sounds are high-pitched and hyperactive. Digital rectal exam reveals an empty rectal vault. Vital signs: [T: X, HR: X, BP: X, RR: X, SpO2: X].
Treatment Protocol
Immediate surgical consultation requested. Patient kept NPO. Initiated aggressive fluid resuscitation with isotonic crystalloids. Placement of nasogastric tube for gastric decompression. Pre-operative imaging (CT abdomen/pelvis with contrast) confirms cecal bascule or axial volvulus. Plan: Urgent exploratory laparotomy with cecopexy or right hemicolectomy depending on bowel viability.