an
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A 36-year-old man sustains a gunshot wound to the left buttock. He is hemodynamically stable. There is no exit wound, and an x-ray of the abdomen shows the bullet to be located in the right lower quadrant. Correct management of a suspected rectal injury includes which of the following?
A.Barium studies of the colon and rectum
B.Barium studies of the bullet track
C.Endoscopy of the bullet track
D.Angiography
E.Sigmoidoscopy in the emergency room
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| kingsofke
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I would go with A,
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| Diego Casali
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This is a Kaplan's question I've already done.
I'm sure. The correct answer is E: we have to look for a rectal injury with a sigmoidoscopy right in the ER.
You can't use barium in an abdominal penetrating injury because it will cause a peritonitis!
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| msyamp
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yes casali. the first three options are abslute contraindiaactions in this case.
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| an
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correct.... answer is E
penetrating injury to rectum should be diagnosed by immed sigmoidoscopy. if inconclusive, do contrast studies with water-soluble radioopaque medium. Barium is C/I -> spillage into peritoneal cavity can result in infection/abscess. Instrumentation of bullet track is C/I -> risk of injury to adjacent organs/vessels. Angiography wont show injury to rectum
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