مريضة عمرها ٧٢ سنة أجرت منظار قولون مع إزالة زوائد قبل ٦ ساعات. الآن تشتكي من ألم بطن شديد متزايد والبطن منتفخ وقاسٍ. الحرارة ٣٨٫٤، النبض ١١٨، الضغط ١٠٠/٦٢. ما الأولوية؟

A 72-year-old woman had colonoscopy with polypectomy 6 hours ago. She now has severe increasing abdominal pain with a distended rigid abdomen. T 38.4 °C, HR 118, BP 100/62. What is the priority?

1. Give oral analgesia now and reassess her pain in two hours
2. Give a laxative to help gas and stool pass
3. Notify the provider now for suspected colonic perforation
4. Encourage walking to pass the remaining gas

Answer: C) Notify the provider now for suspected colonic perforation. Some bloating after colonoscopy is normal, but severe increasing pain with rigidity, fever and tachycardia suggests perforation. Notify immediately, keep NPO, and prepare imaging and fluids.