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SELF/Repair of Perforations/Background Knowledge Quiz

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▼Created by the West African College of Surgeons for the Surgical Education Learners Forum.Please see the Terms of Use and do not edit without permission.
Instructions

Work through each question carefully to choose the best answer, and submit the quiz to view your results. After completing the quiz, read through the answer explanations to review the reasoning behind both correct and incorrect options.

1

A patient presents with sudden severe abdominal pain, rigid abdomen, and free air under the diaphragm on X-ray. Labs show leukocytosis and elevated lactate. What is the most appropriate next step?

Proceed with urgent laparotomy for perforation repair
Begin broad-spectrum antibiotics and plan laparotomy later the same day
Continue resuscitation and observe for clinical progression before deciding on surgery
Obtain an abdominal ultrasound to evaluate for other intra-abdominal pathology

2

A patient with suspected perforation is found to have diffuse bowel ischemia during surgery. What is the most appropriate management approach?

Continue with a Graham patch to preserve bowel length
Proceed with diversion or damage control measures
Attempt primary closure of the perforations
Resection and anastomosis regardless of tissue quality

3

During consent for laparotomy to repair a perforated duodenal ulcer, which explanation is most essential for the patient to understand?

Stoma creation is never required for upper GI perforations
The repair method may change depending on intraoperative findings
Postoperative recovery is typically free of complications
The procedure will always involve direct closure with a Graham patch

4

A patient with abdominal pain has metabolic acidosis and severe pain out of proportion to exam. CT shows mesenteric vessel occlusion but no free air. What is the correct interpretation?

It indicates perforation from typhoid ileitis requiring resection
This presentation is typical for perforated bowel requiring emergent laparotomy
It suggests a mimic of perforation and requires different management
It confirms a small, clean perforation suitable for patch repair

5

During a laparotomy for a presumed single perforation, the surgeon finds multiple large perforations with significant fecal contamination. Which intraoperative approach is most appropriate?

Attempt primary closure on each perforation if tension-free approximation appears possible
Proceed with resection and primary anastomosis in a single stage
Perform segmental resection with consideration of diversion based on contamination and bowel quality
Apply temporary control of contamination and plan a second-look operation without definitive repair


Page data
Keywords surgery, health
SDG SDG03 Good health and well-being
Authors Global Surgical Training Challenge
License CC-BY-SA-4.0
Organizations WACS, SELF
Language English (en)
Related 0 subpages, 0 pages link here
Redirects WACS Training Modules/Repair of Perforations/Background Knowledge Quiz
Views 6 page views (analytics)
Created November 13, 2025 by KatKor
Last edit March 9, 2026 by Ian-laurel
Cite as KatKor (2025–2026). "SELF/Repair of Perforations/Background Knowledge Quiz". Appropedia. Retrieved June 4, 2026.
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