ROSH Gastrointestinal Practice Exam

A woman with abdominal pain, vomiting, and high-pitched bowel sounds after surgeries is most likely diagnosed with?

1. Abdominal hernia

2. Diverticulosis

3. Intussusception

4. Post-operative adhesions

The correct answer is: Post-operative adhesions

The presentation of abdominal pain, vomiting, and high-pitched bowel sounds in a post-surgical patient strongly indicates the likelihood of post-operative adhesions. Adhesions are fibrous bands of scar tissue that can form after surgeries, particularly in the abdominal area. These bands can cause obstruction by binding loops of bowel together or to other structures, resulting in the characteristic symptoms observed. High-pitched bowel sounds are associated with the hyperactive bowel movement as the intestines attempt to overcome the obstruction caused by the adhesions. The vomiting is a result of the bowel's inability to properly transit contents due to the obstruction, which may also lead to a buildup of intestinal fluid and gas. The other conditions listed, while they may present with similar symptoms, are less directly related to the surgical history provided in the scenario. An abdominal hernia might present with similar symptoms, but it typically involves a visible bulge and may not be directly tied to recent surgery in the same way adhesions are. Diverticulosis is primarily characterized by diverticula formation and usually presents with diverticulitis complications but is less associated with acute bowel obstruction immediately post-surgery. Intussusception, while it can occur in adults, is more common in children and would generally have different hallmark