PLAB 1 Question 4

Question.

A 65-year-old gentleman with no previous surgical history, underwent total hip replacement. He complains of abdominal distension, constipation and vomiting but no significant pain 2 days after surgery. Examination reveals absent bowel sounds and xray abdomen shows multiple gas, fluid levels in small and large bowel. Most appropriate initital management in this case could be

1. 1. Urgent exploratory laparotomy
   2. NG tube, electrolyte and fluid balance
   3. Broad spectrum Antibiotics
   4. Rectal tube and decompression