Ischaemic colitis after aortic surgery — MCCQE Part 1 MCQ

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HardAbdominal PainIschaemic colitis after aortic surgeryMCCQE Part 1

A 76-year-old man develops bloody diarrhoea and abdominal pain after open abdominal aortic aneurysm repair and is hypotensive. Which of the following is the most appropriate next step?

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Correct answer: B — Urgent surgical and endoscopic evaluation for ischaemic colitis

Urgent surgical and endoscopic evaluation for ischaemic colitis is the single best answer because the age, timing, examination findings and investigations in the vignette fit Ischaemic colitis after aortic surgery better than the alternatives. The most tempting distractor is less appropriate because it either treats a neighbouring presentation, delays a time-critical intervention, or ignores a key discriminator in the stem. The remaining options are suboptimal because they would miss the diagnosis, use an investigation or treatment in the wrong sequence, or fail to address safety and follow-up. Canadian practice should be anchored to Canadian vascular surgery guidance, with attention to acuity, safety-netting and local provincial pathways.

Reference: Canadian vascular surgery guidance