MBBS OSCE · General Surgery
OSCE — small bowel obstruction after prior laparotomy
Eight-minute OSCE on adhesive SBO: drip-and-suck, CT transition point, ischaemia red flags, and operate-vs-observe decision.
8 min stationVerification in progress
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Exam tags
NEET-PGINICETUSMLEPLAB
Brief (to candidate)
A 55-year-old with prior open appendectomy presents with colicky central pain, bilious vomiting, and absolute constipation. Abdomen is distended with high-pitched bowel sounds. No peritonism initially.
Candidate tasks
- Differentiate mechanical SBO from ileus.
- Start NBM, IV fluids, NG decompression.
- Order labs including lactate.
- Justify CT for transition point and complications.
- State criteria for trial of non-operative care vs emergency surgery.
- Recognise closed-loop / ischaemia red flags.
- Outline hernia and malignant LBO as alternative causes.
Examiner checklist
| Domain | Pass behaviours |
|---|---|
| Immediate care | Drip and suck, catheter, analgesia |
| Ischaemia screen | Continuous pain, lactate, peritonism, CT signs |
| Imaging | CT with IV contrast when stable |
| Adhesive pathway | 24–72 h trial only if no ischaemia |
| Operate now | Closed loop, hernia with strangulation, peritonitis, failed trial |
| Communication | Explain NG purpose and need for serial review |
Model outline
Adhesive SBO is common after laparotomy. Resuscitate and decompress first. Use CT to find the transition point and exclude ischaemia. Observe selected stable adhesive SBO; operate without delay for closed loop, strangulated hernia, or ischaemia markers.