Trauma: duodenal haematoma: 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 · Trauma: duodenal haematoma

Sample item

A 6-year-old boy struck his upper abdomen on a bicycle handlebar and has persistent vomiting 2 days later. CT shows a thickened duodenal wall with intramural haematoma and no free air or contrast leak. What is the appropriate management?

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

The answer and the reasoning

D. Nasogastric decompression and parenteral nutrition with observation

Intramural duodenal haematoma typically follows handlebar or child abuse injury and produces obstruction a day or more later. Without perforation it is managed non-operatively with nasogastric decompression and parenteral nutrition, and most resolve within 1 to 3 weeks. Surgery is considered if obstruction persists beyond roughly 2 weeks or if perforation is suspected.

Option by option

  • A. Immediate Whipple procedure

    Pancreaticoduodenectomy is a drastic operation for extensive destruction, not for a contained haematoma.

  • B. Discharge with oral antiemetics

    Persistent vomiting from obstruction needs decompression and nutrition and not discharge.

  • C. Early laparotomy with duodenal resection

    Early resection is not needed in the absence of perforation or ischaemia.

  • D. Nasogastric decompression and parenteral nutrition with observation (correct)

    Correct. Bowel rest and parenteral nutrition let the haematoma resolve spontaneously.

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.

More General Surgery questions

Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is D, Nasogastric decompression and parenteral nutrition with observation. Intramural duodenal haematoma typically follows handlebar or child abuse injury and produces obstruction a day or more later.

Why is "Immediate Whipple procedure" not the answer?

Pancreaticoduodenectomy is a drastic operation for extensive destruction, not for a contained haematoma.

Why is "Discharge with oral antiemetics" not the answer?

Persistent vomiting from obstruction needs decompression and nutrition and not discharge.

Why is "Early laparotomy with duodenal resection" not the answer?

Early resection is not needed in the absence of perforation or ischaemia.

What concept does this question test?

It tests Trauma: duodenal haematoma in General Surgery. Without perforation it is managed non-operatively with nasogastric decompression and parenteral nutrition, and most resolve within 1 to 3 weeks. Surgery is considered if obstruction persists beyond roughly 2 weeks or if perforation is suspected.

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 Trauma: duodenal haematoma?

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.