Injuries: delayed rupture of the spleen: practice question

A Forensic Medicine 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.

Try it

Forensic Medicine · Injuries: delayed rupture of the spleen

Sample item

A 19-year-old footballer is kicked on the left flank and discharged after a normal assessment. Nine days later he collapses in shock with haemoperitoneum. What is the likely mechanism?

ARupture of the aorta from rapid decelerationBDelayed rupture of the spleen when an enlarging subcapsular haematoma gives wayCPerforation of the duodenum from avulsion of the mesenteryDSpontaneous rupture of a normal spleen unrelated to the kick

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

The answer and the reasoning

B. Delayed rupture of the spleen when an enlarging subcapsular haematoma gives way

Blunt trauma may produce a subcapsular splenic haematoma that expands and ruptures after a latent interval of hours to days. Medicolegally the later death or collapse is attributed to the original assault, because the chain of causation is unbroken.

Option by option

A. Rupture of the aorta from rapid deceleration
Aortic rupture from deceleration is usually immediate and fatal.
B. Delayed rupture of the spleen when an enlarging subcapsular haematoma gives way (correct)
Correct. A subcapsular haematoma can rupture days after the blow.
C. Perforation of the duodenum from avulsion of the mesentery
Duodenal perforation presents with peritonitis, not haemoperitoneum and shock.
D. Spontaneous rupture of a normal spleen unrelated to the kick
A normal spleen rarely ruptures without trauma, and the history gives a clear cause.

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.

Questions about this Forensic Medicine question

What is the answer to this Forensic Medicine question?

The best answer is B, Delayed rupture of the spleen when an enlarging subcapsular haematoma gives way. Blunt trauma may produce a subcapsular splenic haematoma that expands and ruptures after a latent interval of hours to days.

Why is "Rupture of the aorta from rapid deceleration" not the answer?

Aortic rupture from deceleration is usually immediate and fatal.

Why is "Perforation of the duodenum from avulsion of the mesentery" not the answer?

Duodenal perforation presents with peritonitis, not haemoperitoneum and shock.

Why is "Spontaneous rupture of a normal spleen unrelated to the kick" not the answer?

A normal spleen rarely ruptures without trauma, and the history gives a clear cause.

What concept does this question test?

It tests Injuries: delayed rupture of the spleen in Forensic Medicine. Medicolegally the later death or collapse is attributed to the original assault, because the chain of causation is unbroken.

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 Injuries: delayed rupture of the spleen?

Learn postmortem changes with their timelines, and toxicology as poison, sign, test and antidote. Then use the flashcards and the other Forensic Medicine 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.