ATLS Abdominal and Pelvic Trauma 3

Question 1

In a patient with a pelvic fracture and hemodynamic instability, what is the most appropriate initial intervention to control hemorrhage?

Accepted Answer

Application of a pelvic binder

Answer

Emergent laparotomy

Answer

Internal iliac artery ligation

Answer

Angiographic embolization

Question 2

Which type of pelvic fracture is most commonly associated with life-threatening hemorrhage?

Accepted Answer

Anterior-posterior compression (open book) type III

Answer

Lateral compression type I

Answer

Vertical shear

Answer

Lateral compression type II

Question 3

A patient has a positive FAST but is hemodynamically stable after a motor vehicle collision. CT reveals a Grade II liver laceration with no active extravasation. What is the recommended management?

Accepted Answer

Nonoperative management with serial monitoring

Answer

Emergent hepatic lobectomy

Answer

Hepatic artery embolization

Answer

Exploratory laparotomy with packing

Question 4

During laparotomy for abdominal trauma, damage control surgery principles are indicated when the patient develops which triad?

Accepted Answer

Hypothermia, acidosis, and coagulopathy

Answer

Hypertension, bradycardia, and irregular respirations

Answer

Tachycardia, hypoxia, and oliguria

Answer

Fever, leukocytosis, and peritonitis

Question 5

Retroperitoneal duodenal injury is best diagnosed by which finding on CT scan?

Accepted Answer

Retroperitoneal air around the duodenum or right kidney

Answer

Free air under the diaphragm

Answer

Contrast pooling in the pelvis

Answer

Thickened colonic wall

Question 6

What is the most appropriate initial management for a patient with a suspected bladder rupture following blunt pelvic trauma?

Accepted Answer

Retrograde cystography

Answer

Emergent cystoscopy

Answer

CT abdomen without contrast

Answer

Immediate surgical exploration