A patient in th emergency room with road traffic accident has retroperitoneal bleed. Trauma to which of the following structures is the most likely cause of this bleed?: (A) Jejunum, (B) Liver, (C) Stomach, (D) Pancreas
Answer is D. The pancreas is the most likely cause as it is a retroperitoneal structure. All the other structures listed are intraperitoneal. Relationship of viscera to the perritoneum : Intraperitoneal: Stomach, jejunum, ileum, cecum, appendix, transverse colon, sigmoid colon, liver, gallbladder and spleen. Retroperitoneal: Esophagus(abdominal), duodenum(2nd and 3rd segment), pancreas, kidneys, ureters, suprarenal gland, abdominal aoa and its branches, inferior venacava, and celiac plexus. Paially covered in the peritoneum(also considered as retroperitoneal): Ascending colon, descending colon, and rectum. Ref: Gray&;s Anatomy Pgno: 1045