**Question:** Gastric lavage is contra-indicated in:

A. Acute abdomen
B. Hypovolemic shock
C. Cardiac arrest
D. Acute myocardial infarction

**Core Concept:** Gastric lavage is a procedure used to flush the stomach contents for diagnostic or therapeutic purposes. It can be beneficial in cases of suspected ingestion of toxic substances or in poison control situations. However, certain medical conditions or patient conditions can make gastric lavage potentially harmful or contra-indicated.

**Why the Correct Answer is Right:** Gastric lavage is contra-indicated in patients with acute abdomen, as it can exacerbate the existing abdominal pain, cause bowel perforation, or lead to peritonitis due to contamination of peritoneal cavity. In hypovolemic shock, gastric lavage can lead to further blood loss and hemodynamic instability. Gastric lavage is not indicated in cardiac arrest, as it is a life-threatening emergency and requires immediate advanced life support interventions. In acute myocardial infarction, gastric lavage can cause hemodynamic instability due to blood loss and worsen the patient's condition.

**Why Each Wrong Option is Incorrect:** In acute abdomen, performing gastric lavage may worsen the patient's condition rather than improve it. In hypovolemic shock, gastric lavage can cause additional blood loss, further compromising the patient's hemodynamics. In cardiac arrest, gastric lavage is not indicated due to the severity of the condition and the need for immediate advanced life support interventions. In acute myocardial infarction, gastric lavage can lead to hemodynamic instability due to blood loss and exacerbate the patient's condition.

**Clinical Pearl:** In cases of suspected toxic ingestion, consider alternative approaches such as activated charcoal administration or gastric lavage in a controlled manner under close monitoring, rather than blindly proceeding with gastric lavage as a general rule. Assess the patient's condition, prioritize life-threatening emergencies, and choose the most appropriate intervention based on the clinical context.

**Correct Answer:** C. Acute abdomen

**Correct Answer Explanation:** Gastric lavage is contra-indicated in patients with acute abdomen. In such cases, performing gastric lavage can worsen the patient's condition by exacerbating the acute abdomen symptoms and potentially causing bowel perforation or peritonitis due to contamination of the peritoneal cavity. Gastric lavage is not recommended in patients with acute abdomen unless indicated in specific clinical scenarios, such as massive ingestion of a non-absorbable foreign body or a known, potentially toxic substance that needs immediate removal.