Esophagus

Esophagus perforation

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Q) A 45 year old man who has been drinking regularly for the past 15 years vomits after a large meal and complains of severe chest pain. Cardiac cause is ruled out and boerhavve's syndrome is suspected. Which of the following is not true about this condition

a) Gastrograffin tests will confirm the diagnosis

b) Perforation is most common in the left lower end

c) Exploration and full thickness suturing of perforation should be done

d) This condition has a high morbidity and mortality if not diagnosed at time

Answer for premium members  - Discussion on Boerhaave's syndrome

Barrett esophagus

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Q . Barrett's esophagus is a premalignant condition. Which of  the following statement is false regarding Barrett's esophagus

 a) Barrett's mucosa predisposes to Squamous cell carcinoma of esophagus

b) Risk of Cancer is 0.5% per year

c) Prevalence of Barrett's esophagus in general  population is  2-7%

d) Intestinal type of mucosa  with goblet cells is the most  common histopathological finding

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Caustic injuries to esophagus

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Q) Which of the following is not true about reconstruction in caustic injuries to esophagus

a) Caustic injuries to esophagus have 1000 times more risk of developing malignancy

b) Right colon replacement is definately better than left colon

c) The only indication for elective surgery is refractory strictures and possibility of malignancy

d) Most of the surgeons prefer bypass over resection of esophagus

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Conduits of Esophagus

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Q) What is true regarding gastric conduits to be used as esophagus replacement?

a) The right gastric and gastro epiploic arteries can be safely divided to bring stomach to the neck

b) For malignant diseases stomach is the most reliable conduit

c) Stomach has the least incidence of developing reflux esophagitis

d) For benign esophageal strictures stomach is the conduit of choice

Esophageal hiatus hernia

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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

  1. Sliding - GE junction migrates to the mediastinum and rests superior to the diaphragm.
  2. Paraesophgaeal - Part of stomach migrates through the esophageal hiatus into the mediastinum with GE junction remaining at its normal position.

paraesophgeal hiatus hernia

  1. There are IV types of hiatal hernia

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EUS criteria of malignant lymph node

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Q) One of the following is not a criteria of malignancy in lymph node on EUS

a) Size more than 1 cm

b) Prominent intranodal vasculature

c) Sharp well defined  borders

d) Hypoechoic