Abdominal and GI imaging: acute mesenteric ischaemia: practice question

A Radiology 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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Radiology · Abdominal and GI imaging: acute mesenteric ischaemia

Sample item

A 72-year-old man with atrial fibrillation has sudden severe central abdominal pain with a soft, minimally tender abdomen and a rising lactate. Which investigation should be done first?

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

The answer and the reasoning

A. CT angiography of the abdomen

Pain out of proportion to the examination in a patient with atrial fibrillation suggests embolic occlusion of the superior mesenteric artery. CT angiography confirms occlusion and bowel viability quickly. A plain film is often normal early, and barium studies and gallbladder ultrasound are inappropriate.

Option by option

  • A. CT angiography of the abdomen (correct)

    Correct. CT angiography shows the arterial occlusion and bowel condition.

  • B. Barium meal

    Barium studies are contraindicated in an acute abdomen with possible bowel compromise.

  • C. Plain abdominal radiograph with observation

    A plain film is usually normal early and delays diagnosis.

  • D. Ultrasound of the gallbladder

    Gallbladder ultrasound does not assess the mesenteric vessels.

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 Radiology question

What is the answer to this Radiology question?

The best answer is A, CT angiography of the abdomen. Pain out of proportion to the examination in a patient with atrial fibrillation suggests embolic occlusion of the superior mesenteric artery.

Why is "Barium meal" not the answer?

Barium studies are contraindicated in an acute abdomen with possible bowel compromise.

Why is "Plain abdominal radiograph with observation" not the answer?

A plain film is usually normal early and delays diagnosis.

Why is "Ultrasound of the gallbladder" not the answer?

Gallbladder ultrasound does not assess the mesenteric vessels.

What concept does this question test?

It tests Abdominal and GI imaging: acute mesenteric ischaemia in Radiology. CT angiography confirms occlusion and bowel viability quickly. A plain film is often normal early, and barium studies and gallbladder ultrasound are inappropriate.

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 Abdominal and GI imaging: acute mesenteric ischaemia?

Learn signs with the image, and the disease they point to. Then use the flashcards and the other Radiology 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.