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SELF/Repair of Perforations/Repair of Perforations 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 with suspected small-bowel perforation arrives in a district hospital where only spinal or local anesthesia is available. The team prepares the sterile table for an emergent laparotomy. Which set of materials is most appropriate to prioritize for this case?

Endoscopic clips, biopsy forceps, cold snare
Scalpel, Babcock forceps, warm saline, suction, absorbable sutures, omentum instruments
Laparoscope, CO₂ insufflator, stapling device, vascular clamps
Laser cautery, harmonic scalpel, bariatric retractors

2

During midline entry, the surgeon opens the peritoneum and encounters foul fluid under mild pressure. Yankauer suction removes most of it. What is the most appropriate next action in contamination control?

Proceed immediately to search for the perforation
Pack off all quadrants and delay lavage until repair is complete
Lavage only the pelvis to avoid distributing contamination
Begin systematic warm-saline lavage starting with the most contaminated quadrant

3

During laparotomy for suspected perforation, the team completes irrigation and begins examining the bowel. They identify one perforation on the anterior duodenal bulb and continue running the bowel to assess the remaining segments. What principle does this reflect?

Irrigation alone is adequate to identify all clinically significant perforations
Duodenal perforations rarely coexist with other injuries
Systematic inspection is required because additional perforations may be present
Once the primary lesion is identified, further inspection is usually unnecessary

4

A 1.5-cm clean perforation is found on the anterior duodenal bulb with healthy edges. The omentum is well vascularized. Which repair method is most appropriate?

Full-thickness running non-absorbable suture closure
Segmental resection with primary anastomosis
Stapled oversew reinforced with synthetic mesh
Graham patch secured with interrupted absorbable sutures

5

After performing a Graham patch repair, a leak test is done by instilling air via NG tube under a saline pool. Bubbles appear along one edge of the patch. What is the correct next step?

Proceed with closure; minor bubbling is expected
Insert a drain and rely on postoperative healing
Convert to segmental resection automatically
Reinforce the leaking portion with additional seromuscular sutures


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/Repair of Perforations Quiz
Views 3 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/Repair of Perforations Quiz". Appropedia. Retrieved June 4, 2026.
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