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
Acute mechanical large bowel obstruction should be operated early because of the risk of - 
Select and explain. 
A. Respiratory embarrassment due to abdominal distension, B. Electrolyte imbalance from vomiting, C. Septicaemia from bowel contents, D. Closed-loop obstruction and caecal perforation
D: Closed-loop obstruction and caecal perforation
Answer: D: Closed-loop obstruction and caecal perforation 
Explanation: • Virtually all patients with complete acute large bowel obstruction require prompt surgical intervention and should not undergo a trial of non-operative management
• Acute large bowel obstruction in patients with competent ileocecal valve is a true surgical emergency because of high chances of perforation (MC site: Cecum) 
• Once diagnosis has been made, surgical exploration should be undertaken as soon as possible after appropriate resuscitation