Question

A hemodynamically normal 10-year-old girl is hospitalized for observation after a Grade III (moderately severe) splenic injury has been confirmed by computed tomography (CT). Which of the following mandates prompt celiotomy (laparotomy)?

a. Hypotension (systolic blood pressure <90 mm Hg)

b. Hemoglobin level <7 g/dL

c. Contrast extravasation on CT scan

d. Age younger than 5 years

Answer 1

Prompt celiotomy (laparotomy) is mandated when a hemodynamically normal 10-year-old girl with a Grade III splenic injury has hypotension (systolic blood pressure <90 mm Hg).

Step-by-step explanation:

The correct answer is a. Hypotension (systolic blood pressure <90 mm Hg). Hypotension is an important indicator of hypovolemia (abnormally low levels of fluid and blood within the body) and can result from extensive blood loss. In this case, a Grade III splenic injury confirmed by CT scan suggests significant trauma to the spleen, which can cause internal bleeding. Prompt celiotomy (laparotomy) is necessary to identify and treat the source of bleeding and stabilize the patient's condition.