Vascular surgery: aortoenteric fistula: 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 · Vascular surgery: aortoenteric fistula

Sample item

A man with a previous aortic graft has a small self-limiting haematemesis followed by massive bleeding a few days later. Which diagnosis must be considered?

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

The answer and the reasoning

C. Aortoenteric fistula between the graft and the third part of the duodenum

A herald bleed after aortic grafting suggests an aortoenteric fistula, usually into the third or fourth part of the duodenum, often from graft infection. CT angiography or endoscopy guides diagnosis, and treatment is emergency surgery such as extra-anatomic bypass with graft excision or endovascular control.

Option by option

  • A. Oesophageal varices

    Varices need portal hypertension.

  • B. Mallory-Weiss tear

    Mallory-Weiss follows retching.

  • C. Aortoenteric fistula between the graft and the third part of the duodenum (correct)

    Correct. A herald bleed is typical.

  • D. Peptic ulcer perforation

    Ulcer does not link to the graft.

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 C, Aortoenteric fistula between the graft and the third part of the duodenum. A herald bleed after aortic grafting suggests an aortoenteric fistula, usually into the third or fourth part of the duodenum, often from graft infection.

Why is "Oesophageal varices" not the answer?

Varices need portal hypertension.

Why is "Mallory-Weiss tear" not the answer?

Mallory-Weiss follows retching.

Why is "Peptic ulcer perforation" not the answer?

Ulcer does not link to the graft.

What concept does this question test?

It tests Vascular surgery: aortoenteric fistula in General Surgery. CT angiography or endoscopy guides diagnosis, and treatment is emergency surgery such as extra-anatomic bypass with graft excision or endovascular control.

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 Vascular surgery: aortoenteric fistula?

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.