Voluntary Guarding But No in Surgery — 27yo Man | Trauma Surgery | SMLE Q#11070
SMLE Question #11070
Surgery
Trauma Surgery
Objective: OBJ-TRM-AIRWAY-01
Last updated: February 2026
A 27-year-old man presents 7 days after emergency pancreatectomy, splenectomy, and partial colectomy for a left-sided gunshot wound. For 2 days, he has had fever, chills, and worsening sharp left upper quadrant pain that is pleuritic. Examination shows marked left upper quadrant tenderness with voluntary guarding but no generalized peritonitis; the laparotomy wound is clean and dry. What is the most appropriate next step in evaluation?
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