When a hollow organ is punctured during a penetrating injury to the abdomen:

• A. it commonly protrudes through the injury site.
• B. the abdomen will become instantly distended.
• C. peritonitis may not develop for several hours.
• D. it will bleed profusely and rapidly cause shock.

Answer: (C)

When a hollow organ is punctured in the abdomen, the contents spill into the peritoneal cavity and trigger inflammation and infection over time. This process takes hours to develop, so peritonitis may not appear immediately after the injury. In other words, there can be a delayed onset of peritoneal signs even though a perforation has occurred. The other statements describe more immediate or dramatic changes that aren’t as reliably expected: protrusion of tissue through the wound isn’t typical with hollow-viscus perforation, distension isn’t guaranteed to happen instantly, and severe, rapid bleeding with shock is not the usual immediate consequence of a hollow organ puncture unless a major vessel is also injured.