This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Surgery
[{'content': 'In intestinal obstruction, investigations needed are -a) Barium swallowb) Intestinal barium mealc) Stomach barium meald) Erect X-ray abdomene) Supine X-ray abdomen \nSelect and explain. \nA. bde, B. ade, C. ace, D. bce', 'role': 'user'}, {'content': 'Answer: A \nExplanation: The diagnosis of intestinal obstruction is suspected in any patient presenting with abdominal pain, vomiting, distension and obstipation.\nPlain radiographs usually confirm the clinical suspicion and can also define the site of obstruction.\n\n\nMaingot\'s 10/e, p 1163 writes that 4 x-ray views of the abdomen are essential in all pts. suspected of intestinal obstruction.\ni)\xa0upright chest, upright abdomen, iii) supine abdomen & iv) left lateral decubitus view.\nwhereas Sabiston, Harrison & CSDT write for only 2 views - the erect abdomen & the supine abdomen.\nAlso know that Bailey 24/e, p 1189 writes that "Erect abdominal films are no longer routinely obtained and the radiological diagnosis is based on a supine abdominal film. An erect film may subsequently be requested when further doubt exists"\nOther investigations which may be done are:\n\nCT scan\n\nCT is useful in cases in which diagnosis is not readily apparent by plain abdominal film, or if an abdominal tumor or abscess is suspected to be the cause of obstruction.\nCT is helpful in identifying the location and cause of obstruction.\n\nBarium studies\n\nA barium enema is done if a large bowel obstruction is suspected.\nBarium studies for small bowel obstructions are\nBarium meal follow through (BMFT)\nEnteroclysis (small bowel enema)\nthese studies are done in patients in whom a recurring or low-grade mechanical obstruction is suspected.\nthese studies are contraindicated in acute obstructions - Bailey 24/e, p 1190\nBMFT & enteroclysis are also contraindicated in large bowel obstruction as barium may get insipissated in the colon.', 'role': 'assistant'}]