Try it
General Surgery · Hepatobiliary and pancreatic surgery: liver trauma
Sample itemA 20-year-old after a road traffic accident has a grade III liver laceration on contrast CT. His blood pressure is 120/80 mmHg, his pulse is 84 per minute and he has no other injury. What is the management?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
C. Non-operative management with monitoring
Haemodynamically stable patients with liver injuries are managed non-operatively with observation, serial examination and imaging, with angioembolisation if bleeding continues. Laparotomy is for instability or peritonitis.
Option by option
A. Immediate laparotomy with packing
Laparotomy is reserved for the unstable patient.
B. Hepatic lobectomy
Resection is not indicated for a stable laceration and carries high mortality.
C. Non-operative management with monitoring (correct)
Correct. Stable liver injuries are managed non-operatively.
D. Diagnostic peritoneal lavage
Lavage is a diagnostic test and CT has already defined the 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.
More General Surgery questions
- HerniaA groin hernia that passes medial to the inferior epigastric vessels through Hesselbach'…
- BurnsA 70 kg adult has burns over 40% of the body surface. By the Parkland formula, what tota…
- HerniaA hernia that enters the inguinal canal through the deep ring, lateral to the inferior e…
- Intestinal obstructionWhat is the commonest cause of small bowel obstruction in adults?