High School

A 60-year-old man presents with severe abdominal pain that started 10 hours ago. The pain is increasing in severity and is colicky in nature. The patient has not had a bowel movement for 3 days. In the last 2 days, he vomited what he ate 4 times. He appears tired and dehydrated. On examination, increased bowel sounds were noticed. There is also a mass in the right inguinal area. The patient stated that the mass has been present for 10 years but disappears when he lies on his back.

What is the investigation of choice to confirm the diagnosis?

1. Abdominal X-Ray Erect film
2. Abdominal Ultrasound
3. CBC
4. Colonoscopy
5. Upper GIT endoscopy

Answer :

Final answer:

The investigation of choice to confirm the diagnosis is an abdominal X-Ray Erect film.

Explanation:

The investigation of choice to confirm the diagnosis in this case would be Abdominal X-Ray Erect film.

Given the patient's presentation of severe abdominal pain, colicky in nature, with no bowel movement for 3 days, vomiting, dehydration, and a mass in the right inguinal area that disappears when lying on the back, it is highly suspicious for obstructive bowel disease, specifically an inguinal hernia.

An abdominal X-ray in an erect position would be the most appropriate investigation to confirm this diagnosis. It can show visually the presence of bowel obstruction, air-fluid levels, and the presence of a hernia.

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