A 46-Year-Old Man Is Brought to the Emergency Department After

question 401

Multiple Choice

A 46-year-old man is brought to the emergency department after being involved in a motor vehicle collision.  He is unresponsive and his injuries include a basilar skull fracture, brain contusion, fractures of ribs 7-10, hemopneumothorax on the right, and a pelvic fracture.  After multiple blood product transfusions, placement of a chest tube, and pelvis fixation, his condition stabilizes.  On the 5th day of his hospital stay, he is minimally responsive and has spontaneous respirations.  Examination shows diminished bowel sounds and facial grimacing with palpation of the right upper quadrant of the abdomen.  Rectal examination shows no abnormalities.  Nasogastric tube aspiration shows retention of gastric contents.  An abdominal CT scan reveals gaseous distension of the small and large bowels without air-fluid levels.  The gallbladder is distended with no gallstones; there is small amount of pericholecystic fluid.  Which of the following is the most likely cause of this patient's condition?

• A)Acalculous cholecystitis
• B)Duodenal perforation
• C)Mesenteric ischemia
• D)Pancreatitis
• E)Small-bowel obstruction

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Definitions:

Shareholders

Individuals or entities that own shares in a corporation and have potential voting rights and the possibility of dividends.

Stakeholders

Individuals or groups that have an interest, financial or otherwise, in the performance and actions of an organization or project.

Bandwagon Fallacy

The misleading argument that something is true, good, or desired because many other people believe in it or do it.

Argumentum Ad Baculum

A logical fallacy in which an argument is made through appeal to force or threat instead of reason.