An 80-year-old patient from a high-level care nursing home presents with constipation, abdominal distension and confusion.

1. List four diagnoses with a primary colon pathology that should be sought before diagnosing chronic constipation, with a matching CT finding for each. 8 marks

A diagnosis above is given. The patient has an ACD stating he does not wish for invasive procedures, CPR/ICU/intubation, but is ok for ward-based care. His daughter is the Enduring Guardian.

2. Briefly state four elements of your ongoing management 4 marks