04-09-2017, 01:51 AM
A 38 years old man is brought to the E/R you are working on. The patient was involved in a motor vehicle accident. He is unresponsive. There are many injuries in his bodies including skull fracture, brain contusion, fracture ribs 7-11 on the right side with hemophnumothoeax and also a pelvic fracture. You decide put a chest tube and do pelvic fixation after which his condition slowly stabilizes. On the day six, his GCS is found to be 8 and still unresponsive but with spontaneous respiration. On examination there is diminished bowel sounds. You decide to put a NG tube and it showed retention of gastric contents. You ordered a CT abdomen which showed distention of small and large bowels without any air fluid levels but with dissension of gall bladder and pericholecystic fluid but no gallstones. Which of the following is your most likely diagnosis?
A. Bowel Obstruction
B. Mesenteric Ischeamia
C. Ischemic Colitis
D. Cholecystitis
E. Pancreatitis
F. Pulmonary Contusion
A. Bowel Obstruction
B. Mesenteric Ischeamia
C. Ischemic Colitis
D. Cholecystitis
E. Pancreatitis
F. Pulmonary Contusion