AIIMS MCQ

GI SUrgery MCQs from AIIMS over the years

Modified Nissen’s fundoplication

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Q ) Modified Nissen's Fundoplication is 

a) 2700 anterior wrap around esophagus

b) 2400 wrap

c) 3600 wrap over > 52 Fr for 1 – 2 cm

d) 600 wrap over 42 Fr for 4 cm

Answer

c

Nissen fundoplication is complete 360 degree but has high incidence of gas bloat. To counter, this modification done to wrap over 52 F tube for 1-2 cm

Belsey - Left thoracotomy, mobilization of distal esophagus and stomach, hiatus opened from above,  fundus is brought 270 degrees around distal esophagus. Then the whole assembly is brought down and crura is repaired.

Hill procedure - No fundoplication is done

Toupet is anterior fundoplication either 240 degree or 270 degree.

 

Early adenocarcinoma of esophagus

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Q. Early adenocarcinoma of Esophagus

a) Around one third have lymph node mets

b) EMR curative in approx 90%

c) EMR can remove all dysplastic epithelium

d) In high grade dysplasia esophagectomy reveals around 50% invasive malignancy

Premium answer

This question in another format was also discussed at www.mcqsurgery.com/esophagus4

Cholelithiasis with Choledocholithiasis

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Q.  Patients with gallstones and choledocholithiasis in a centre with endoscopy, interventional radiology and tertiary care 

a.       Single setting lap chole + CBDE better than endoscopy followed by lap chole

b.      In choledocholithiasis endoscopic clearance alone without lap chole can be done without any long term complication

c.       For impacted ampullary stones with CBD dilatation that requires biliary enteric drainage is performed with a preferred open approach

Answer

 

Two field esophagectomy

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Q) Which is not included in two field esophagectomy in carcinoma esophagus

a) Supra carinal and cervical

b) Infra carinal and celiac

c) Superior mediastinal

d) d) Posterior mediastinal

Premium members

Discusss the lymph node stations

Japanese and european classifications of esophageal spread

Two field esophagectomy

 

Timing after esophagus perforation

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Q) Management of esophagus perforation after 96  hours in a 40 year old patient with pulse 110/min and BP 110/80 Best option

a) Antibiotics and drainage of left pleural effusion

b) Primary repair of esophagus

c) Esophagectomy and gastric pull up

d) Cervical Esophagus diversion 

Questions on Esophagus

Discussion on all treatment modalities and which to use when

 

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