Acute abdomen
1. A 6-year-old child with a history of sickle cell anaemia, has known heart valve diseases
presents with severe abdominal pain and tenderness. What is the likely cause?
A. Acute appendicitis
B. Splenic sequestration crisis
C. Mesenteric ischemia
D. Acute cholecystitis
2. A 10-year-old boy presents with sudden onset right lower quadrant pain, rebound
tenderness, and fever. What is the best initial diagnostic test?
A. Abdominal ultrasound
B. CT scan of the abdomen
C. Complete blood count
D. barium enema
3. A 5-year-old child with acute abdominal pain and bilious vomiting undergoes an abdominal
X-ray, which shows air-fluid levels. What is the most likely diagnosis?
A. Small bowel obstruction
B. Acute appendicitis
C. Gastroenteritis
D. Pancreatitis
4. A neonate presents with abdominal distension, bilious vomiting, and failure to pass
meconium. What investigation will confirm the diagnosis of Hirsch sprung disease?
A. Contrast enema
B. Rectal biopsy
C. Abdominal ultrasound
D. Plain X-ray of the abdomen
5. A 4-week-old male infant is brought to the pediatrician by his parents due to frequent
vomiting after feeds. The vomiting is non-bilious, forceful, and projectile. The infant appears
hungry after vomiting and feeds eagerly but vomits again. The parents report that he has fewer
wet diapers than usual and seems lethargic. On examination, there is a palpable "olive-like" mass
in the right upper quadrant of the abdomen.
What is the most likely diagnosis in this infant?
A. Duodenal atresia
B. Gastroesophageal reflux disease
C. Pyloric stenosis
D. Intussusception
6. A 4-year-old child presents with acute abdominal pain and jaundice. What laboratory test is
most relevant to identify biliary causes?
A. Liver function tests
B. Serum amylase and lipase
C. Complete blood count
D. Electrolytes
7. A 6-month-old infant with intussusception is diagnosed early. What is the first-line
management?
A. Exploratory laparotomy
B. IV antibiotics and observation
C. Air or contrast enema reduction
D. Nasogastric decompression
8. A neonate with volvulus due to malrotation presents with bilious vomiting. What is the
definitive treatment?
A. Ladd’s procedure
B. Contrast enema reduction
C. Antibiotics and supportive care
D. Bowel resection
9. A child recovering from an appendectomy for ruptured appendicitis develops a high fever and
abdominal pain 5 days later. What is the most likely complication?
A. Adhesive intestinal obstruction
B. Intra-abdominal abscess
C. Wound dehiscence
D. Fecal fistula
10. A child with untreated intussusception presents with signs of sepsis and peritonitis. What is
the most likely complication?
A. Bowel perforation
B. Adhesions
C. Hemorrhage
D. Small bowel obstruction
11. A 2-day-old male neonate is brought to the emergency department with complaints of
abdominal distension and failure to pass meconium since birth. On examination, the abdomen is
distended, and a rectal examination leads to the expulsion of a large amount of stool. A contrast
enema shows a narrow distal rectum and sigmoid colon with proximal bowel dilatation. What is
the most likely diagnosis?
A) Meconium ileus
B) Necrotizing enterocolitis
C) Hirschsprung disease
D) Intestinal atresia
