Certified Neuroscience Registered Nurse (CNRN) Practice Exam

What is a critical initial imaging step if there is suspicion of an anastomotic leak?

1. Ultrasound

2. CT scan

3. X-ray

4. MRI

The correct answer is: CT scan

A CT scan is considered a critical initial imaging step when there is suspicion of an anastomotic leak. This is due to the scan’s ability to provide high-resolution images of the abdomen and pelvis, allowing for effective visualization of the gastrointestinal tract and the anastomotic sites. In the case of a leak, contrast material can also be used to highlight areas of concern, helping to confirm the diagnosis by identifying extravasation of contrast outside the normal lumen of the intestine. Ultrasound, although useful in certain scenarios for evaluating fluid collections or abscesses, may not provide the detailed information required to assess the gastrointestinal anastomosis accurately. An X-ray may have limited utility in detecting specific leaks unless there is a significant contrast spill or perforation. MRI is less commonly used in acute settings due to longer acquisition times and less availability, making it impractical for rapid diagnosis of potential leaks. Hence, the CT scan stands out as the most effective initial imaging modality in this context.