Gastrointestinal surgery: diverticular haemorrhage: 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 · Gastrointestinal surgery: diverticular haemorrhage

Sample item

A 72-year-old man passes a large volume of fresh red blood per rectum. After resuscitation his pulse and blood pressure are stable, but bleeding continues and an urgent colonoscopy cannot identify the source because of blood. Known diverticulosis is present. What is the best next investigation?

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

The answer and the reasoning

D. CT angiography

In brisk lower gastrointestinal bleeding with a non-diagnostic colonoscopy, CT angiography is the preferred next test. It localises active bleeding and guides embolisation or surgery. Barium studies and capsule endoscopy are unsuitable in an actively bleeding patient.

Option by option

  • A. Barium enema

    A barium enema is not used in acute bleeding and would obscure later endoscopy or angiography.

  • B. Plain abdominal radiograph

    A plain film cannot show a bleeding point.

  • C. Capsule endoscopy

    Capsule endoscopy is slow and unsuitable for ongoing brisk haemorrhage.

  • D. CT angiography (correct)

    Correct. It is fast, widely available and shows the site of active extravasation.

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.

More General Surgery questions

Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is D, CT angiography. In brisk lower gastrointestinal bleeding with a non-diagnostic colonoscopy, CT angiography is the preferred next test.

Why is "Barium enema" not the answer?

A barium enema is not used in acute bleeding and would obscure later endoscopy or angiography.

Why is "Plain abdominal radiograph" not the answer?

A plain film cannot show a bleeding point.

Why is "Capsule endoscopy" not the answer?

Capsule endoscopy is slow and unsuitable for ongoing brisk haemorrhage.

What concept does this question test?

It tests Gastrointestinal surgery: diverticular haemorrhage in General Surgery. It localises active bleeding and guides embolisation or surgery. Barium studies and capsule endoscopy are unsuitable in an actively bleeding patient.

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 Gastrointestinal surgery: diverticular haemorrhage?

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.