A man with anterior resection and end to end anastomosis done complains of severe pain in the
chest and abdominal distension. What is the most appropriate inv likely to review the cause this
deterioration?
a. XR abdomen
b. Exploratory laparoscopy
c. CT
d. US
e. Laparotomy
answer: C
budd chiari........RV flow obstruction > rapid ascites
imaging modality of choice in budd chiari syndrome is: Angogram although invasive is gold standard. USG has sensitivity and specificity. CT and MRI findings are diagnostic in a minority of cases, radionucleotide scan is quite nonspecific. therefore choice 'd'-USG is the correct answer for suspected BCS.
ReplyDeleteThere was no hint to hepatic vein obstruction ,the diagnosis is more likely an anastomotic leak or internal bleeding as suggested by dr Khalid. In that case, laparotomy can be both diagnostic and therapeutic
ReplyDelete