Q) Not an indication of surgery in hydatid cyst liver
a) CE2 cyst with multiple daughter cysts
b) Large 10 cm cyst situated peripherally
c) Infected cyst
d) 6 cm asymptomatic cyst
All the following would be seen after splenectomy for hereditary spherocytosis except?
a) Persistence of spherocytosis
b) Anemia
c) Same osmotic fragility
d) Normal life span of erythrocytes
Primary Sclerosing Cholangitis
Q) Which is not an indication of liver transplantation in primary sclerosing cholangitis?
a) Intractable pruritis
b) Recurrent episodes of cholangitis
c) Cholangiocarcinoma
d) Dominant stricture
Esophageal hiatus hernia
Q) What is type III esophageal hernia?
a) Paraesophageal hiatus hernia
b) Sliding hiatus hernia
c) Both sliding and paraesophageal hernia
d) Large part of stomach in the mediastinum with pylorus near the esophageal hiatus
Answer c
Hiatal hernias are protrusion of stomach through a defect in the esophageal hiatus into the mediastinum.
They are of four types of hiatus hernia
- Sliding - GE junction migrates to the mediastinum and rests superior to the diaphragm.
- Paraesophgaeal - Part of stomach migrates through the esophageal hiatus into the mediastinum with GE junction remaining at its normal position.
- There are IV types of hiatal hernia
Q Most common urological complication in Crohn’s disease is
a) Ureteral obstruction
b) Entero vesical fistula
c) Pyonephrosis
d) Recto uretheral fistula
Hemangioma Liver
Q) A 38 year lady undergoes USG abdomen for vague pain abdomen. ON USG she has a large 12 cm lesion in the right lobe of liver, which on CT turns out to be hemangioma. True about management of hemangioma liver
a) All hemangioma more than 10 cm should be resected
b) OCPs and pregnancy should be avoided in young females as there is risk of rupture
c) Arterial embolization should be routinely done in large hemangiomas
d) If surgery is decided hemangioma located at the periphery should be enucleated
Complications of Billroth II surgery
Complications of Billroth II – Free MCQ (GI Surgery)
High-yield stomach surgery question for NEET SS & GI Surgery preparation. Use the Answer Free button to reveal the explanation.
Q) What is true regarding complications of Billroth II surgery?
Answer c -
In Billroth II surgery, afferent limb obstruction is more common
In Billroth I reconstruction The remnant is anastomosed to the duodenum
In Billroth II duodenum stump is closed and stomach is anastomosed to the jejunum limb
Advantages of Billroth I
- More Physiological as normal GI continuity is maintained
- No problem of afferent and efferent limb
- Future procedures like endoscopy and ERCP can be done
- Reduced chance of gastric carcinoma in remnant stomach as compared to Billroth 2 ( SKF page 682)
In surgery for benign gastric ulcers, Billroth I reconstruction is the preferred choice.
Billroth II surgery has problems of
- Retained antrum syndrome
- Afferent loop obstruction
- Duodenal stump leak (1-3%
Billroth 2 surgery is done when there is
1. Inadequate mobility of the duodenum
2. Scarring of duodenum
Complications of gastric surgery
Complications of gastrectomy
- Nutritional and weight loss - Iron deficiency, Copper deficiency, Vit B12 , Anemia
- Delayed gastric emptying
- Roux statsis- Seen in roux en y loops- Pain, nausea, vomiting, abdominal bloating
- Cholelithiasis- Higher incidence in roux en y reconstruction as compared to B1 and B 2 gastrectomy
- Recurrent ulceration
Complications of Billroth 2 surgery
- Dumping syndrome Dumping symptoms have been reported in up to 70% of Billroth II patients and up to 75% of patients after RYGBP for obesity.
- Afferent loop obstruction - It can be minimized by keeping the length of afferent loop less than 20 cm and using a retrocloic approach.
- Bile reflux gastritis - More common with billroth I and billroth 2 surgery, incidence is decreasing after the use roux en y anastomosis
Splenic artery aneurysm
Q) Splenic artery aneurysm is seen in ( #spleen1)
a) Proximal 1/3rd of splenic artery
b) Proximal 2/3 of splenic artery
c) Middle 1/3 of splenic artery
d) Distal 1/3 of splenic artery
Mass forming lesion Liver
Q) A 55 year old male presents with obstructive jaundice. Ultrasound evaluation reveals a
hyperechoic 4 cm mass in segment VI of liver with peripheral duct dilatation.
CT abdomen shows a hypodense mass with delayed enhancement in portal pahse.
What is the most likely diagnosis
a) Hepatocellular carcinoma
b) Intrahepatic cholangiocarcinoma
c) Metastatic Adenocarcinoma
d) Carcinoid
Ulcerative colitis and Crohn’s disease
Q) All of the following are seen in both ulcerative colitis and crohn's disease except
a) Aphthous ulcer
b) Pseudo polyp
c) Rectal disease
d) Obstructive symptoms