A patient in the emergency room with a road traffic accident has retroperitoneal bleed. Trauma to which of the following structures is most likely the cause of the bleed: (A) Liver, (B) Stomach, (C) Jejunum, (D) Pancreas
Answer is D. The pancreas is the most likely cause as it is a retroperitoneal structure.All the structures listed are intraperitoneal Relationship of the viscera the peritoneum: *INTRAPERITONEAL:Stomach,jejunum,ileum,caecum,appendix,transverse colon, sigmoid colon, liver, gall bladder, spleen *RETROPERITONEAL:Esophagus(abdominal),duodenum 2 ND and 3rd pa, pancreas, kidney, ureter, suprarenal glands, abdominal aoa, and it's branches ,inferior Vena cabs, and Celiac plexus *PAIALLY COVERED IN THE PERITONEUM(also considered as retroperitoneal) :Ascending colon, descending colon, rectum RETROPERITONEAL STRUCTURES retroperitoneal structures are posterior to the peritoneal sac and do not have a Mnemonic:SAD PUCKER S-suprarenal gland A-aoa D-dudenum 2nd and 3rd pa P-pancreas except the tail C-celiac plexus and colon (ascending and descending colon) K -kidneys E -esophagus Reference:Grays anatomy,41st edition page number 1045 andv1046