A 27-year-old man presents to the emergency department with rectal pain and abdominal distension that has progressively worsened over the past week. He denies having any bowel movements during this time period due to the pain. Physical exam is notable for the finding above. Which of the following is the next step in management of this patient?

A 78-year-old woman who had a left hip fracture and surgical fixation 1 month ago and has resided in a care facility since then presents to the emergency department with abdominal pain and distention associated with vomiting for 3 days. She has not had a fever or diarrhea. She has a history of osteoporosis and dementia. She has not had any other previous surgeries. Vital signs show a heart rate of 92 bpm, blood pressure of 123/70 mm Hg, and temperature of 36.5°C. She is thin and debilitated. Her lungs are clear, and her heart is without murmurs. She has mild abdominal distention and diffuse tenderness without rebound or guarding. There is no stool in the rectal vault. Her abdominal imaging is shown above. What initial management step should the clinician take?

A 42-year-old healthy man presents with abdominal pain and distension. His upright abdominal X-ray is shown above. Which of the following is the appropriate treatment for the most likely condition?

A 4-week-old previously healthy infant is brought to the emergency department by his parents with a complaint of sudden onset of bilious emesis without change in his bowel habits. The infant appears ill and inconsolable. Physical examination reveals abdominal distention. What is the most appropriate next step in management?

In the United States, which of the following conditions, other than postoperative adhesions, is most likely responsible for causing the diagnosis seen in the image above?

Which of the following hernias is paired with the correct anatomical location?

An 85-year-old nursing home patient presents with diffuse abdominal pain and distension and nausea, but no vomiting. The above abdominal radiograph is obtained. What is the management of this patient?

A 50-year-old man presents with chronic nonbloody, watery, voluminous diarrhea associated with abdominal cramping over the last month. He also states he intermittently experiences episodes of skin flushing, primarily involving his face, neck, and chest, that lasts for minutes and resolves spontaneously. He reports no recent travel or antibiotic usage. Which of the following is expected to be elevated in this patient’s urine sample?

A 21-year-old man presents to the emergency department with 1 day of fever and abdominal distension. He has been having bloody diarrhea for the past week, which has happened intermittently over the past year, but he was concerned with the new symptoms. He is ill appearing and has a temperature of 38.5°C, HR of 128 bpm, and BP of 95/55 mm Hg. Abdominal exam is notable for distension and diffuse tenderness. A CT scan of the abdomen is shown above. Which of the following is an important component of the initial management?