Q) 75 year old man complains of obstipation for 2 days. He has taken laxatives but continues to have worsening pain and distension associated with vomiting. He underwent b/l knee replacement 2 weeks back. He was on Inj fentanyl for pain control. He is on antihypertensives and lipid lowering agents for the past 15 years.
On examination he is afebrile, oriented, pulse rate of 100 min/, BP 120/60 and abdomen is distended with mild tenderness. There are no signs of peritonitis, bowel sounds are sluggish.
TLC is 6,500, and potassium is 3.2 . All other blood tests are normal. X ray abdomen and CT abdomen shows dilated large bowel loops and oral contrast upto splenic flexure.
What is the probable diagnosis
a) Ischemic colitis
b) CMV colitis
c) Colonic Pseudoobstruction
d) Caecal volvulus
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