A 68-year-old male musician presents to the emergency department with a sudden onset of colicky abdominal pain and massive vomiting of 4-hour duration. Examination shows an elevated WBC of 13,200 with a HCT of 45%. Electrolytes and blood urea nitrogen (BUN) are normal. An erect film of the abdomen reveals dilatation of the stomach with distended loops of bowel. What is his clinical diagnosis?
Correct Answer: Complete proximal intestinal obstruction
Description: Mechanical obstruction implies a barrier that impedes progress of intestinal contents. Complete mid or distal small-bowel obstruction presents with colicky abdominal pain, more marked abdominal distention but with vomiting that is less frequent and occurs at a later stage than that of proximal jejunal obstruction.
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