General Surgery, Trauma & Burns · NEET PG Preparation Surgery
A 35-year-old male is brought to the emergency department following a high-speed motor vehicle collision. He is hypotensive (BP 80/50 mmHg), tachycar…
Practice question from General Surgery, Trauma & Burns (NEET PG Preparation Surgery), with the correct answer and a step-by-step solution.
medium · MCQ · Q-E3E8D6
A 35-year-old male is brought to the emergency department following a high-speed motor vehicle collision. He is hypotensive (BP 80/50 mmHg), tachycardic (heart rate 130/min), and unresponsive. Focused Assessment with Sonography for Trauma (FAST) reveals free fluid in the perihepatic, perisplenic, and pelvic regions. Which of the following is the most appropriate immediate next step in management?
- A.Diagnostic peritoneal lavage (DPL)
- B.Immediate exploratory laparotomyCorrect answer
- C.Contrast-enhanced computed tomography (CECT) of the abdomen and pelvis
- D.Aggressive crystalloid resuscitation until normal blood pressure is achieved
Solution
In a hemodynamically unstable trauma patient with a positive FAST exam indicating intra-abdominal hemorrhage, the immediate management is exploratory laparotomy to control the source of bleeding. CECT is only indicated in hemodynamically stable patients. Aggressive crystalloid resuscitation before surgical control (permissive hypotension protocol) is preferred over full normalization of BP to avoid dislodging clots.
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