Mesenteric ischaemia: acute embolus: 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.

Try it

General Surgery · Mesenteric ischaemia: acute embolus

Sample item

A 70-year-old with atrial fibrillation develops sudden severe abdominal pain with a soft abdomen and no peritonism. Lactate is raised. After resuscitation and heparin, what is the best next investigation?

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

The answer and the reasoning

B. CT angiography of the mesenteric vessels

Acute embolic mesenteric ischaemia typically involves the superior mesenteric artery and causes pain out of proportion to examination. CT angiography confirms the occlusion and guides embolectomy, endovascular therapy and resection of non-viable bowel. Delay beyond a few hours leads to transmural infarction.

Option by option

  • A. Serum amylase and wait

    A normal amylase does not exclude mesenteric ischaemia, and waiting is dangerous.

  • B. CT angiography of the mesenteric vessels (correct)

    Correct. CT angiography is the investigation of choice.

  • C. Plain abdominal film only

    A plain film is insensitive for early ischaemia.

  • D. Barium meal

    Barium studies are contraindicated and unhelpful.

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 B, CT angiography of the mesenteric vessels. Acute embolic mesenteric ischaemia typically involves the superior mesenteric artery and causes pain out of proportion to examination.

Why is "Serum amylase and wait" not the answer?

A normal amylase does not exclude mesenteric ischaemia, and waiting is dangerous.

Why is "Plain abdominal film only" not the answer?

A plain film is insensitive for early ischaemia.

Why is "Barium meal" not the answer?

Barium studies are contraindicated and unhelpful.

What concept does this question test?

It tests Mesenteric ischaemia: acute embolus in General Surgery. CT angiography confirms the occlusion and guides embolectomy, endovascular therapy and resection of non-viable bowel. Delay beyond a few hours leads to transmural infarction.

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 Mesenteric ischaemia: acute embolus?

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.