Hepatobiliary and pancreatic surgery: pancreatic trauma: practice question

A General Surgery question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Surgery · Hepatobiliary and pancreatic surgery: pancreatic trauma

Sample item

After a handlebar injury to the epigastrium, a boy has persistent pain, raised amylase, and CT shows transection of the pancreatic body with a disrupted main duct. What is the recommended operation?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Distal pancreatectomy with or without splenic preservation

Main duct injury to the left of the mesenteric vessels is managed by distal pancreatectomy. Head injuries are drained, and Whipple is reserved for severe combined injury with duodenum. Missed duct injury leads to fistula, pseudocyst and abscess.

Option by option

  • A. Total pancreatectomy

    Total resection is excessive.

  • B. Distal pancreatectomy with or without splenic preservation (correct)

    Correct. Distal resection treats body transection with duct disruption.

  • C. Observation only

    Duct disruption does not heal by observation.

  • D. Whipple procedure

    Whipple is reserved for severe head injury.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is B, Distal pancreatectomy with or without splenic preservation. Main duct injury to the left of the mesenteric vessels is managed by distal pancreatectomy.

Why is "Total pancreatectomy" not the answer?

Total resection is excessive.

Why is "Observation only" not the answer?

Duct disruption does not heal by observation.

Why is "Whipple procedure" not the answer?

Whipple is reserved for severe head injury.

What concept does this question test?

It tests Hepatobiliary and pancreatic surgery: pancreatic trauma in General Surgery. Head injuries are drained, and Whipple is reserved for severe combined injury with duodenum. Missed duct injury leads to fistula, pseudocyst and abscess.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Hepatobiliary and pancreatic surgery: pancreatic trauma?

Learn classic signs and eponyms alongside what they diagnose. Then use the flashcards and the other General Surgery questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.