Small bowel: enterocutaneous fistula closure: 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 · Small bowel: enterocutaneous fistula closure

Sample item

Which factor is most likely to prevent spontaneous closure of an enterocutaneous fistula?

AWell-nourished patientBLow output of less than 200 mL per dayCFistula tract longer than 2 cmDDistal obstruction

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

The answer and the reasoning

D. Distal obstruction

Spontaneous closure is hindered by the mnemonic FRIEND: foreign body, radiation, infection or inflammatory bowel disease, epithelialisation, neoplasm and distal obstruction. Distal obstruction maintains high intraluminal pressure that keeps the tract open. Low output, a long tract and good nutrition favour closure.

Option by option

A. Well-nourished patient
Good nutrition aids healing.
B. Low output of less than 200 mL per day
Low output fistulas are more likely to close.
C. Fistula tract longer than 2 cm
A long tract favours closure, while a short tract hinders it.
D. Distal obstruction (correct)
Correct. Distal obstruction keeps the fistula open.

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 D, Distal obstruction. Spontaneous closure is hindered by the mnemonic FRIEND: foreign body, radiation, infection or inflammatory bowel disease, epithelialisation, neoplasm and distal obstruction.

Why is "Well-nourished patient" not the answer?

Good nutrition aids healing.

Why is "Low output of less than 200 mL per day" not the answer?

Low output fistulas are more likely to close.

Why is "Fistula tract longer than 2 cm" not the answer?

A long tract favours closure, while a short tract hinders it.

What concept does this question test?

It tests Small bowel: enterocutaneous fistula closure in General Surgery. Distal obstruction maintains high intraluminal pressure that keeps the tract open. Low output, a long tract and good nutrition favour closure.

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 Small bowel: enterocutaneous fistula closure?

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.