Case 9 - 15

Question 1

P association with chronic liver disease, particularly cirrhosis.

Answer 1

HCC

Question 2

acute epigastric pain radiating to the back, elevated lipase, and enlarged pancreas indicate acute.

Answer 2

pancreatitis

Question 3

The presence of a well-circumscribed liver lesion with a central scar likely represents an incidental finding of

Answer 3

focal nodular hyperplasia (FNH),

Question 4

central, stellate scar,

Answer 4

FNH

Question 5

the development of the following symptoms and signs in patients with recent BAT should raise suspicion for undiagnosed pancreatic injury:

Answer 5

• Persistent abdominal discomfort/tenderness
• Persistent nausea/emesis
• Increasing amylase over serial measurements
• Peripancreatic fluid collection (due to pancreatic duct injury)

Question 6

Presentation of acute mesenteric ischemia

Answer 6

• Rapid onset of periumbilical pain (often severe)
• Pain out of proportion to examination findings
• Hematochezia (late complication)

Question 7

Intestinal angina”: Dull, crampy, postprandial abdominal pain leading to food aversion and weight loss

Answer 7

Chronic mesenteric ischemia

Question 8

Abdominal pain out of proportion to tenderness on physical exam . Pain is colicky and di use, typically in mid-abdomen.

Answer 8

AMI

Question 9

usually occurs in critically ill, hospitalized patients. Patients often have jaundice as well as pain and/or a mass in the upper right quadrant.

Answer 9

Acalculas cholecystitis

Question 10

laboratory testing of AMI

Answer 10

Leukocytosis
elevated hemoglobin (hemoconcentration)
elevated amylase
and metabolic acidosis (lactate)

Question 11

Acute, severe abdominal pain is less likely. In :

Answer 11

Alcohol withdrawal

Question 12

subphrenic abscess.

Answer 12

This patient underwent a laparoscopic appendectomy 10 days ago and now has right upper quadrant pain, fever, leukocytosis, and pulmonary manifestations (shortness of breath, hiccups, right-sided effusion),

Question 13

This patient underwent a laparoscopic appendectomy 10 days ago and now has right upper quadrant pain, fever, leukocytosis, and pulmonary manifestations (shortness of breath, hiccups, right-sided effusion), suggest

Answer 13

Sub phrenic abscess

Question 14

are the most common complication of appendectomy

Answer 14

Infections

Question 15

is significantly greater with laparoscopic appendectomy than laparotomy.

Answer 15

intrabdominal abscess

Question 16

Diagnosis of intabdominal abscess

Answer 16

Diagnosis usually requires CT scan of the abdomen

Question 17

can cause fever, right upper quadrant pain, and leukocytosis: however, most patients are jaundiced (not anicteric), and a pleural effusion/hiccups would be atypical.

Answer 17

Choledocholithiasis

Question 18

is associated v,ith fever, leukocytosis, and pulmonary infiltrate; hovvever, most cases occur <5 days postoperatively. In addition abdominal pain, abdominal distension, and reduced bowel sounds are not typical features

Answer 18

Hospital-acquired pneumonia (HAP)

Question 19

adhesions typically take months to form,

Answer 19

Mechanical bovvel obstructions

Question 20

is common up to 5 days after abdominal procedures and often presents with hypoxemia and dyspnea.
Fever, significant leukocytosis, abdominal pain, and reduced bowel sounds are not typically associated with this condition.

Answer 20

Mechanical bovvel obstructions

Question 21

is a common postoperative complication and may cause shortness of breath, pleural effusion, and fever. Abdominal pain, abdominal distension, and decreased bowel sounds are not typical.

Answer 21

Pulmonary embolism

Question 22

Soft, nontender bulge at umbilicus

Answer 22

Congenital umbilical hernia

Question 23

Eviscerated bowel with no covering membrane

Answer 23

Gastroschisis

Question 24

Sac containing multiple organs

Answer 24

Omphalocele

Question 25

This elderly women has progressive abdominal pain, nausea/vomiting (leading to dehydration with dry mucous membranes and elevated creatinine), abdominal distension, and high-pitched bowel sounds on examination. In association with the abdominal x-rays demonstrating distended loops of bowel with air-fluid levels, this presentation suggests a

Answer 25

small bowel obstruction (SBO).

Question 26

(strangulation

Answer 26

ischemia and necrosis

Question 27

when hernia contents become trapped v,ithin the hernia sac, which can result in SBO; reduced venous outflow eventually leads to ischemia and necrosis (strangulation).

Answer 27

Incarcerated hernia

Question 28

typically occur as a complication of Crohn disease or intraabdominal surgery.

Answer 28

Small bowel adhesions and strictures

Question 29

typically occurs with chronic mesenteric ischemia and affects the splenic flexure and rectosigmoid junction of the colon.

Answer 29

Watershed bowel hypoperfusion

Question 30

Are increase risk of gastric cancer

Answer 30

/ أوروبا / جنوب امريكياDiet ( rich in salt-preserved food and nitroso compounds, ) , H.bacter infection, smoking , pernicious anemia

Question 31

Chronic pancreatitis often causes

Answer 31

epigastric pain and nausea/vomiting, but the pain usually radiates to the back and is worse after
eating.

Question 32

Etiology of chronic pancreatitis

Answer 32

“Alcohol use
• Cystic fibrosis (common in children)
•Ductal obstruction (eg, malignancy, stones)
• Autoimmune