A difficult abdominal case

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Likely BO.
Relatively young pt, need to know his past Hx Re: previous surgeries, Hx of melanoma etc. If never had surgery then would take him to OR after carrefully reviewing CT. 
if has had previous abdo Sx then likely adhesive and the usual mgt is conservative first and if no improvement then OR (in his case, would give him a day max since he already has been symptomatic for 5dd).
in any case, would start with resus and reviwing the CT to see what's causing his BO (mass vs adhesions vs intussusc which is unlikely but possible w lymphoma, TB, melanoma, bile stone ileus etc).
 
gud luk!
K


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