INI-CET 2018

Q: A patient presented to the emergency department with severe abdominal pain. An erect radiograph was performed. Based on the findings, what should be the management?

Laparotomy. ***Laparotomy*** - **Pneumoperitoneum** (free air under diaphragm) on erect X-ray indicates **perforated viscus**, requiring immediate surgical exploration and repair. - Emergency **laparotomy** allows identification of perforation site, peritoneal lavage, and definitive repair to prevent **sepsis** and **peritonitis**. *Gastric lavage* - Used for **gastric decontamination** in poisoning cases or **upper GI bleeding**, not for perforated viscus. - Does not address the underlying **perforation** and may worsen contamination by increasing intragastric pressure. *ICD insertion* - **Intercostal drainage** is indicated for **pneumothorax** or **pleural effusion**, not abdominal pathology. - **Pneumoperitoneum** requires surgical intervention, not chest tube drainage. *USG FAST* - **Focused Assessment with Sonography in Trauma** is used to detect **free fluid** in trauma patients. - While useful for diagnostic purposes, it does not provide **definitive management** for established perforation requiring immediate surgery.

71 Questions — Page 8 of 8

All (71)Anatomy (22)Anatomy (1)Biochemistry (1)Community Medicine (3)Dermatology (4)Forensic Medicine (8)Microbiology (4)Ophthalmology (3)Orthopaedics (4)Pathology (5)Pathology (2)Pediatrics (1)Physiology (2)Psychiatry (1)Radiology (3)Surgery (3)Surgery (4)

Surgery

1 questions

Q71Medium

A patient presented to the emergency department with severe abdominal pain. An erect radiograph was performed. Based on the findings, what should be the management?