Which finding would most strongly indicate a postoperative complication requiring immediate evaluation after Roux-en-Y surgery on postoperative day 2?

Which finding would most strongly indicate a postoperative complication requiring immediate evaluation after Roux-en-Y surgery on postoperative day 2?

• A. Insert nasogastric tube
• B. Administer broad-spectrum antibiotics
• C. Peritonitis
• D. WBC count

Answer: (C)

Peritonitis signals a life-threatening intra-abdominal complication that requires immediate evaluation, especially after a Roux-en-Y procedure where an anastomotic leak or intra-abdominal infection is possible. On postoperative day two, the presence of severe, increasing abdominal pain with a rigid or distended abdomen, guarding, fever, tachycardia, and signs of sepsis strongly points to peritoneal irritation from a leak or other intra-abdominal catastrophe. This situation demands urgent surgical assessment and rapid stabilization. Other options are more about management or non-specific results. An NG tube is commonly used postoperatively to decompress the stomach and doesn’t by itself indicate a new complication. Administering broad-spectrum antibiotics is a treatment step, not a presenting finding. A single elevated white blood cell count can occur with surgical stress and is not specific for a urgent abdominal complication.

Peritonitis signals a life-threatening intra-abdominal complication that requires immediate evaluation, especially after a Roux-en-Y procedure where an anastomotic leak or intra-abdominal infection is possible. On postoperative day two, the presence of severe, increasing abdominal pain with a rigid or distended abdomen, guarding, fever, tachycardia, and signs of sepsis strongly points to peritoneal irritation from a leak or other intra-abdominal catastrophe. This situation demands urgent surgical assessment and rapid stabilization.

Other options are more about management or non-specific results. An NG tube is commonly used postoperatively to decompress the stomach and doesn’t by itself indicate a new complication. Administering broad-spectrum antibiotics is a treatment step, not a presenting finding. A single elevated white blood cell count can occur with surgical stress and is not specific for a urgent abdominal complication.