Q ) A 25 year old male brought to the hospital after being involved in a road traffic accident that occurred 50 minutes ago. His initial BP at the scene of accident was 80/40 mm HG with a pulse rate of 120/min.
The paramedics administered 2 litres of normal saline in the ambulance and in the emergency department his BP is 110/70 with a pulse rate of 90/min.
He has tenderness in Left upper quadrant abdomen and USG reveals perisplenic fluid. Next step is to : (#See more trauma MCQS)
a) Take him for exploratory laparotomy
b) Shift him to ICU and observe
c) Do a CT scan of the abdomen
d) Put in a laparoscope and assess
This Patient has a splenic injury due to blunt trauma abdomen. The immediate management depends on grade of splenic injury and response to IV Fluids. This patient is hemodynamically stable after IV fluids and immediate laparotomy is not needed.
Direct shifting to ICU is also not the right choice because CT is required first and for more severe injuries patient can go to OT
Q) A 55 year old lady presents with vague pain in right lower abdomen. Physical examination reveals a well defined mass there which is non tender and freely mobile. It is non pulsatile as well. What is the most likely possibility?
a) Appendicular mass
b) Mesenteric cyst
c) Perforated tubo ovarian mass
d) Meckel's diverticulum
Mesenteric cysts are uncommon lesions found in this age group. It typically presents as a freely mobile mass which moves perpendicular to small blwel axis. It is painless as well.
Appendicular mass will have a preceding history of pain abdomen
Similarly perforated tubo ovarian mass will also have a history of pain
Meckel's diverticulum does not present as this kind of mass