Abdominal imaging: CT in suspected perforation: practice question

A Radiology 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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Radiology · Abdominal imaging: CT in suspected perforation

Sample item

An elderly man has sudden severe abdominal pain with a rigid abdomen, and an erect chest film shows no free gas. The suspicion of perforation remains high. What is the next best investigation?

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

The answer and the reasoning

B. CT abdomen, which detects small amounts of free gas and the site of perforation

A chest film can miss small perforations, while CT is much more sensitive for free gas, fluid and the cause of perforation, and also assesses other pathology. Barium is avoided in suspected perforation.

Option by option

  • A. Ultrasound of the thyroid

    Thyroid ultrasound is unrelated.

  • B. CT abdomen, which detects small amounts of free gas and the site of perforation (correct)

    Correct. CT is the preferred test when plain film is negative but suspicion is high.

  • C. Barium meal

    Barium is contraindicated in suspected perforation.

  • D. Repeat plain film in 1 week

    Waiting a week is dangerous in peritonitis.

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 Radiology question

What is the answer to this Radiology question?

The best answer is B, CT abdomen, which detects small amounts of free gas and the site of perforation. A chest film can miss small perforations, while CT is much more sensitive for free gas, fluid and the cause of perforation, and also assesses other pathology.

Why is "Ultrasound of the thyroid" not the answer?

Thyroid ultrasound is unrelated.

Why is "Barium meal" not the answer?

Barium is contraindicated in suspected perforation.

Why is "Repeat plain film in 1 week" not the answer?

Waiting a week is dangerous in peritonitis.

What concept does this question test?

It tests Abdominal imaging: CT in suspected perforation in Radiology. Barium is avoided in suspected perforation.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. 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 Abdominal imaging: CT in suspected perforation?

Learn signs with the image, and the disease they point to. Then use the flashcards and the other Radiology 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.