Question

Which are clinical or investigative features of intestinal obstruction?

• A. Abdominal distension
• B. Vomiting
• C. Fluid level in X-ray more than 4
• D. a and b

Hint:

Distension and vomiting are real signs; the X-ray fluid-level cut-off given here is unreliable.

Answer 1

The Correct Option is D

Step 1: Intestinal obstruction classically presents with the tetrad of colicky pain, vomiting, distension, and failure to pass flatus or stool. Among the listed choices, both distension and vomiting belong to this tetrad, confirming options A and B.

Step 2: The radiological cut-off in option C, more than 4 fluid levels, is unreliable, since small numbers of air-fluid levels occur even in normal individuals.

Step 3: Texts point out that 3 to 5 short fluid levels under 2.5 cm, often in the right lower quadrant, can appear without obstruction or ileus, and the figure that genuinely suggests obstruction is more than 5 air-fluid levels rather than more than 4.

Step 4: So distension and vomiting are valid features while the more than 4 fluid-level rule is not, making the combined option a and b the right answer.

\[\boxed{\text{a and b (Abdominal distension and Vomiting)}}\]