A patient has absolute constipation, colicky pain, vomiting and a distended abdomen. Plain X-ray shows dilated small bowel loops with air-fluid levels. What is the likely diagnosis?

Answer and explanation

Correct answer: A. Small bowel obstruction

  1. Step 1: Colic, vomiting and distension with dilated loops indicate obstruction.
  2. Step 2: The commonest cause in developed countries is adhesions.
Answer
Small bowel obstruction.
Why not the others: 'Paralytic ileus with no pain' usually lacks colic; 'Acute appendicitis' does not cause the X-ray pattern; 'Peptic ulcer disease' does not cause obstruction on X-ray.

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