Small bowel: enterocutaneous fistula management: 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 management

Sample item

A patient develops a high-output enterocutaneous fistula on postoperative day 6, with 1.5 L per day output and dehydration. What is the first priority?

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

The answer and the reasoning

C. Fluid and electrolyte resuscitation with sepsis control

Management follows the sequence of resuscitation, sepsis control, nutritional support, defining anatomy by imaging, and then definitive surgery after several months. Early re-operation in a hostile abdomen is hazardous. Skin protection and output control are essential.

Option by option

  • A. Immediate re-laparotomy for fistula closure

    Early closure usually fails and risks further injury.

  • B. Oral feeding to increase absorption

    Oral feeding would increase fistula output in a high-output fistula.

  • C. Fluid and electrolyte resuscitation with sepsis control (correct)

    Correct. Resuscitation and sepsis control are first.

  • D. Discharge with a stoma bag

    Discharge without resuscitation is unsafe.

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 General Surgery question

What is the answer to this General Surgery question?

The best answer is C, Fluid and electrolyte resuscitation with sepsis control. Management follows the sequence of resuscitation, sepsis control, nutritional support, defining anatomy by imaging, and then definitive surgery after several months.

Why is "Immediate re-laparotomy for fistula closure" not the answer?

Early closure usually fails and risks further injury.

Why is "Oral feeding to increase absorption" not the answer?

Oral feeding would increase fistula output in a high-output fistula.

Why is "Discharge with a stoma bag" not the answer?

Discharge without resuscitation is unsafe.

What concept does this question test?

It tests Small bowel: enterocutaneous fistula management in General Surgery. Early re-operation in a hostile abdomen is hazardous. Skin protection and output control are essential.

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 Small bowel: enterocutaneous fistula management?

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.