<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 38-year-old man arrives at the emergency department with severe periumbilical, colicky pain and abdominal distention for the past 2 days. He is nauseated and reports vomiting light-green emesis 8 times since yesterday morning. He has not had a bowel movement or passed any gas for the past 3 days. He has a past medical history of ventral hernia repair 5 years ago. His heart rate is 110min, respiratory rate is 24min, temperature is 38.0C 100.4F, and blood pressure is 12090 mm Hg. The abdomen is distended and mildly tender to deep palpation. Bowel sounds are high-pitched and tinkling. Which of the following is the most likely cause?? A: Cholecystitis, B: Crohns disease, C: Diverticulitis, D: Small bowel obstruction, E: Viral gastroenteritis,  <response>: This is a clinical vignette describing a 38-year-old man with severe abdominal pain, distention, nausea, vomiting, and obstipation. Key findings include colicky periumbilical pain, high-pitched bowel sounds, fever, and history of prior ventral hernia repair. The onset was 2 days ago and the symptoms are progressively worsening, which points to an acute process rather than a chronic condition. The location and nature of the pain, associated nauseavomiting, obstipation, and physical exam findings are classic for small bowel obstruction. The prior ventral hernia repair increases risk for adhesive small bowel obstruction. Cholecystitis would cause RUQ pain and tenderness. Crohns disease and diverticulitis would manifest more gradually. Viral gastroenteritis would not cause obstipation. Therefore, small bowel obstruction is the most likely diagnosis.D: Small bowel obstruction 