GI Surgery & Hepatobiliary · NEET PG Preparation Surgery
During an emergency exploratory laparotomy for a penetrating stab wound to the right upper quadrant, a surgeon encounters a large, expanding, unconta…
Practice question from GI Surgery & Hepatobiliary (NEET PG Preparation Surgery), with the correct answer and a step-by-step solution.
hard · MCQ · Q-5CC978
During an emergency exploratory laparotomy for a penetrating stab wound to the right upper quadrant, a surgeon encounters a large, expanding, uncontained hematoma in zone II of the retroperitoneum. What is the standard management for this hematoma?
- A.Immediately open the retroperitoneum and identify the bleeding vesselCorrect answer
- B.Leave an expanding zone II retroperitoneal hematoma untouched unless it ruptures
- C.Pack the abdomen, perform temporary closure, and transfer for angioembolization
- D.Perform a diagnostic peritoneal lavage
Solution
Zone II retroperitoneum contains the kidneys, renal vessels, and descending/ascending colon. Expanding or pulsatile hematomas in Zone II must be explored mandatorily to control hemorrhage from the renal vessels or retroperitoneal organs. (Non-expanding zone II hematomas are generally left alone unless associated with hematuria or suspicion of injury).
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