A 70 year old male with a history of chronic constipation presents with abdominal pain.  The patient has normal vitals.  The xray below is taken.

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What is the treatment?

A. Lactulose

B.Straight to the OR for operative management

C. Observation

D. Barium Enema

E. Rectal Tube

 

Answer : E.  If the patient has normal vitals and labs, sigmoid volvulus can be treated with a rectal tube.  The patient’s electrolytes should also be corrected.  If there is indication of sepsis or ischemia, then the patient will need to go to the OR because it…wait for it…

 

Damn Near Killed ‘Em!