A 56 year old woman has not passed stools for the last 14 days. Xray shows no air fluid levels. Probable diagnosis is :: (A) Paralytic ileus, (B) Aganglionosis of the colon, (C) Intestinal pseudo-obstruction, (D) Duodenal obstruction
Answer is C. Air fluid levels are unusual in intestinal pseudoobstruction and should raise the possibility of mechanical obstruction. Ref: Harrison's Internal Medicine, 14th Edition, Page 1650 and 15th Edition, Page 1697; Update Gastroenterology 2004: New Developments in the Management of Benign gastrointestinal Disorders, 2004, Page 103.