Trauma: liver injury: 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: liver injury

Sample item

A 32-year-old man with a grade IV blunt liver laceration is haemodynamically stable after 1 litre of crystalloid. CT shows active contrast extravasation (blush) within the parenchyma but no hollow viscus injury. What is the best management?

AAngioembolisation in a unit capable of monitoring and interventionBImmediate laparotomy and hepatectomyCDischarge home with a review in a weekDPeritoneal lavage

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

The answer and the reasoning

A. Angioembolisation in a unit capable of monitoring and intervention

Stable patients with blunt hepatic trauma are managed non-operatively, and the high success rate improves further with angioembolisation when CT shows a contrast blush or pseudoaneurysm. Unstable patients, or those with peritonitis or associated hollow viscus injury, need laparotomy with packing and the Pringle manoeuvre as needed.

Option by option

A. Angioembolisation in a unit capable of monitoring and intervention (correct)
Correct. Angioembolisation controls an arterial blush in a stable patient and avoids laparotomy.
B. Immediate laparotomy and hepatectomy
Emergency hepatectomy carries high mortality and is not needed in a stable patient.
C. Discharge home with a review in a week
A grade IV injury with active bleeding needs inpatient monitoring and treatment.
D. Peritoneal lavage
Peritoneal lavage is a historical diagnostic tool and does not control haemorrhage.

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 General Surgery question

What is the answer to this General Surgery question?

The best answer is A, Angioembolisation in a unit capable of monitoring and intervention. Stable patients with blunt hepatic trauma are managed non-operatively, and the high success rate improves further with angioembolisation when CT shows a contrast blush or pseudoaneurysm.

Why is "Immediate laparotomy and hepatectomy" not the answer?

Emergency hepatectomy carries high mortality and is not needed in a stable patient.

Why is "Discharge home with a review in a week" not the answer?

A grade IV injury with active bleeding needs inpatient monitoring and treatment.

Why is "Peritoneal lavage" not the answer?

Peritoneal lavage is a historical diagnostic tool and does not control haemorrhage.

What concept does this question test?

It tests Trauma: liver injury in General Surgery. Unstable patients, or those with peritonitis or associated hollow viscus injury, need laparotomy with packing and the Pringle manoeuvre as needed.

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 Trauma: liver injury?

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.