Abdomen: duodenum: practice question

A Anatomy 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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Anatomy · Abdomen: duodenum

Sample item

After a handlebar injury a boy has epigastric pain and vomiting. CT shows gas bubbles around the right kidney and the duodenum, but no free air under the diaphragm. A rupture of the second part of the duodenum is found. Why is there no pneumoperitoneum?

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

The answer and the reasoning

A. The second part is retroperitoneal, so the leak enters the retroperitoneal space

The second and third parts of the duodenum are secondarily retroperitoneal, fixed to the posterior abdominal wall in front of the right kidney. A perforation of this part leaks gas and fluid into the retroperitoneum, so free intraperitoneal air may be absent. The first part is largely intraperitoneal.

Option by option

  • A. The second part is retroperitoneal, so the leak enters the retroperitoneal space (correct)

    Correct. A retroperitoneal organ leaks behind the peritoneum, so free air under the diaphragm may be absent.

  • B. The omentum seals every duodenal perforation immediately

    The omentum may limit some perforations but cannot explain gas around the kidney.

  • C. The duodenum hangs on its own mesentery and leaks into the lesser sac

    The duodenum is not suspended on a mesentery; it is fixed to the posterior wall.

  • D. The second part is covered by peritoneum on all sides, so gas stays in the lesser sac

    Only the anterior surface of the second part has peritoneum; its posterior surface lies directly on the right kidney, so gas does not stay in the lesser sac.

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 Anatomy question

What is the answer to this Anatomy question?

The best answer is A, The second part is retroperitoneal, so the leak enters the retroperitoneal space. The second and third parts of the duodenum are secondarily retroperitoneal, fixed to the posterior abdominal wall in front of the right kidney.

Why is "The omentum seals every duodenal perforation immediately" not the answer?

The omentum may limit some perforations but cannot explain gas around the kidney.

Why is "The duodenum hangs on its own mesentery and leaks into the lesser sac" not the answer?

The duodenum is not suspended on a mesentery; it is fixed to the posterior wall.

Why is "The second part is covered by peritoneum on all sides, so gas stays i…" not the answer?

Only the anterior surface of the second part has peritoneum; its posterior surface lies directly on the right kidney, so gas does not stay in the lesser sac.

What concept does this question test?

It tests Abdomen: duodenum in Anatomy. A perforation of this part leaks gas and fluid into the retroperitoneum, so free intraperitoneal air may be absent. The first part is largely intraperitoneal.

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 Abdomen: duodenum?

Learn every nerve by its route, its muscles and what a lesion looks like at the bedside. That one habit answers a large share of questions. Then use the flashcards and the other Anatomy 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.