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MMLU / A 63-year-old woman is in the hospital recovery room 4 hours after elective left…

Problem

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question

A 63-year-old woman is in the hospital recovery room 4 hours after elective left hemicolectomy for colon carcinoma at the splenic flexure. She has a preoperative written directive for no blood products through transfusion for religious reasons. Medical history is significant for hypertension and coronary artery disease. The nurse tells you the patient's blood pressure has progressively declined since the operation. Vital signs now are temperature 35.8°C (96.4°F), pulse 130/min, respirations 20/min, and blood pressure 80/50 mm Hg. Physical examination discloses a slightly distended abdomen with an intact incision. ECG shows sinus tachycardia. Urine output has been 10 mL during the past 2 hours. Hematocrit is 30%; preoperative hematocrit was 41%. The patient has received 4 L of intravenous crystalloid in the recovery room. Reported operative blood loss was 200 mL. Drainage from the nasogastric tube is clear. Damage to which of the following structures is most likely responsible for these findings?

choices

  1. Epigastric artery
  2. Liver
  3. Middle colic artery
  4. Spleen

subject

professional_medicine

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Source and history

task_id
98dc1166-1d85-5e58-9b1b-720dc9ea7216
task_key
all--test--98dc1166-1d85-5e58-9b1b-720dc9ea7216
task_revision_id
1
config / split
all / test

Official source

initial import