Intestinal obstruction

All are true of intestinal obstruction except

A. Small bowel obstructions (SBOs) are more common than large bowel obstructions
B. The most frequent indication for surgery on the small intestines is bowel obstruction
C. The most common cause of all large bowel obstruction is adenocarcinoma
D. Ulcerative colitis is the most common cause of benign stricture seen in the adult population

Strangulation is more commonly seen in

A. Closed-loop obstructions
B. Partial obstructions
C. Complete obstructions
D. Intraluminal obstructions

Releasing the constricting ring in an obstructed hernia is contraindicated in

A. The foramen of Winslow
B. Mesenteric defects
C. Duodenojejunal fossa
D. All of the above

Most common cause of small bowel stricture is

A. Tuberculosis
B. Crohn’s disease
C. Lymphoma
D. Adenocarcinoma

All are true of Richter hernia except

A. The femoral ring is the most common site
B. There is a fall in the incidence of Richter hernias due to minimally invasive surgery
C. The antimesenteric portion of the bowel is mostly affected
D. The mortality rate surrounding strangulated Richter hernias is 17%

Rigler’s triad includes all except

A. Small bowel obstruction
B. Pneumobilia
C. Atypical mineral shadow on radiographs
D. Stercolithe

In short

Predisposition to phytobezoars results from a high fiber intake, inadequate chewing, previous gastric surgery, hypochlorhydria and loss of the gastric pump mechanism.

In Western countries where abdominal operations are common, adhesions and bands are the most common cause of intestinal obstruction.

Hyperplasia of Peyer’s patches in the terminal ileum may be the initiating event causing intussusception in infancy. In most children, the intussusception is ileocolic.

A secondary volvulus, which is the more common variety, is due to rotation of a segment of bowel around an acquired adhesion or stoma.

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