Question 2
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Question Number: 22
question 25
Miscellaneous
Benign Disease- A 23-year-old man fell off a bull while riding and later suffered an isolated injury to the left perineal region by one of the bulls’ horns. At the emergency department, he was hemodynamically intact, and had a perineal penetrating injury measuring approximately 6 × 5 cm. Abdominal examination findings were benign. Computed tomography of the abdomen and pelvis noted approximately 35% circumferential extraperitoneal rectal injury. In addition to initiating broad-spectrum antibiotics and proctoscopy, what is the next step in management?
- A 53-year-old male renal transplant recipient receiving tacrolimus and prednisone presents with acute sigmoid diverticulitis with specks of free air and a 5-cm pelvic abscess which is not amenable to percutaneous drainage. His vital signs are a temperature of 102.0°F (38.9°C), heart rate 105 beats/min, blood pressure 110/80 mm Hg, and white blood cell count 18,000/µL (18109/L). The best next step in management is:
- A 75-year-old man presents with a 1-week history of progressive abdominal distention and a 2-day history of obstipation. He is afebrile and his vital signs are within normal limits. On examination, he has massive abdominal distention and there is tympany to percussion, but no signs of peritonitis. Computed tomography reveals a large bowel obstruction with a whirl sign on the left side of the abdomen. There are no signs of bowel ischemia or perforation. What is the best next step in management?
Pelvic Floor
Perioperative
Anorectal Disease
Malignancy






