The Limiting Reagent for Peristalsis

Abstract

Question: A 62-year-old woman with a history of renal cell carcinoma surgically managed via left nephrectomy and small bowel obstructions treated surgically presented with 4 days of oral intolerance and abdominal distention. Her last bowel movement and flatus were 3 days prior. She was afebrile, vital signs stable, with a white blood cell count of 12.9 × 103/μL. Computed tomography findings were significant for marked distension of the stomach and proximal duodenum, with a transition point in the left midabdomen and distal collapsed loops of small bowel and colon.