Q) Carcinoid syndrome wrong statement is?
a) 40 % have Right heart dysfunction in carcinoid syndrome
b) >1cm in appendix is indication for Right hemi colectomy
c) 30 % jejunoileal carcinoid are metastatic
d) Resection of primary is done in presence of metastatic disease
Q) In Crohns disease of duodenum , patient has a duodenal abscess which is drained. He develops a fistula with ileal communication. Surgery with the least chance of success would be
a. Ileal reaction and duodenal bypass
b. Ileal resection an dudodenal HMplasty c. Ileal freshen and closure d. Duodenum vertical closure
Q) Small intestine diverticula true statement is a. Meckel is Most common and jejuno ileal is least common but most symptomatic b. Meckel is true and congenital and rest are false and acquired c. 1-5 % Duodenal ones require endoscopic or surgical treatment d. All Meckel’s resected unless strong Contraindication is there
Q) False about intestinal TB? # Gen surgery infections 1. Hyperplastic variety has colonic strictures 2. Raised markers,anaemia,positive sputum culture point towards diagnosis 3. BMFT shows pulled up cecum 4. IFN gamma assay is diagnostic
Ans A) STRICTURES ARE OF SMALL BOWEL
There are two types Of Intestinal TB
Ulcerative type - Transverse ulcers with undermined edges, Serosa of bowel is studded with tubercles. It is a severe form of disease
Hyperplastic - Hyperplasia and thickening of terminal ileum. Narrowing of lumen., Stricture and fibrosis occues of terminal ileum
Enteropathy T cell lymphoma is an unusual variant of intestinal lymphoma. It is associated with celiac disease and responds to gluten free diet. It has a higher rate of perforations because of circumferential ulcers. It is commonly seen in jejunum and ileum
Ref- Schakelford Surgery of Alimentary canal pg 1205