ROSH Gastrointestinal Practice Exam

In the case of an 83-year-old man with abdominal distention and vomiting, which treatment may be beneficial in relieving his condition?

1. Barium enema

2. Exploratory laparotomy

3. Magnesium citrate

4. Neostigmine

The correct answer is: Magnesium citrate

In this scenario, the commendable choice for relieving the abdominal distention and vomiting in an elderly man would be the use of magnesium citrate. This agent serves as an osmotic laxative, which can help in cases of constipation-induced bowel obstruction. Given that this patient is presenting with symptoms that suggest a possible obstruction, administering magnesium citrate can help stimulate bowel movement and alleviate the distention by drawing water into the intestines, which can aid in softening stool and promoting evacuation. Magnesium citrate is often employed in situations where a patient may be suffering from a functional blockage due to fecal impaction. Since the older population is more susceptible to complications arising from decreased bowel motility, this treatment can be particularly helpful in managing constipation-related issues without the need for invasive procedures. The other options, while potentially relevant in different contexts, do not directly address the likely cause of the patient's symptoms in this particular scenario. Barium enema is typically used for imaging purposes and can aggravate a bowel obstruction. Exploratory laparotomy involves surgical intervention which may not be immediately justified without further assessment of the patient's condition. Neostigmine is an agent that can stimulate gastrointestinal motility but is more commonly used in cases of acute colonic pseudo-obstruction, and may