Jejunum

Indications of Small Bowel transplant

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Q ) One of the following is not an indication for small bowel transplant?

a)  Impending liver failure by PNALD

b) Multiple thromboses of central veins 

c)  Single episode of catheter-related infection requiring hospitalization in any year

d) single episode of fungal line infection

 

 

Ingested foreign bodies

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Q) False statement about ingested foreign bodies is 

a) Conservative management in most patients

b)  Cathartic agents are part of conservative management

c) Sharp objects can cause perforation

d) Laparotom  is  indicated for  obstruction

 

Contra Indication of stricturoplasty

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Q) All are contraindications of stricturoplasty in crohn's disease of small intestine except?

a) Perforation of intestine

b) Fistula or abscess at stricturoplasty site

c) Multiple strictures in long  segment

d) Albumin < 2 g/dl

 

Intussusception in childhood

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Q) Most common intussusception in children is

a) Ileocolic

b) Ileoileal

c) Ileoileocolic

d) Colocolic

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GIST

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Q) True statement regarding GIST is  (AIIMS 2019)

a) 80% of GIST arise from stomach

b) ILeal GIST is resistant to Imatinab

c) Leiomyosarcomas do not express CD 117

d) Prognosis of GIST does not depend on the site of lesion 

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c
 They can appear anywhere within the GI tract, although they are usually found in the stomach (40% to 60%), small intestine (30%), and colon (15%).
 Development of imatinib mesylate has significantly altered previous treatment strategies. Imatinib mesylate is a tyrosine kinase inhibitor that blocks the unregulated mutant c-kit tyrosine kinase and inhibits the BCR-ABL and PDGF tyrosine kinases.
Current guidelines suggest that patients with high-risk disease should receive 3 years of adjuvant  therapy at all sites
Sabiston page 1280
Ileal GIST are more malignant than stomach GIST

Leiomyosarcomas

Among the gastric tumors, there were no examples of true leiomyosarcomas, whereas there were four small intestinal, four colonic, and two rectal tumors that histologically showed features of differentiated smooth muscle cells with blunt-ended nuclei and eosinophilic, sometimes granular, cytoplasm. These tumors were, by definition, all positive for SMA, and seven also were positive for desmin. Although all leiomyosarcomas were generally negative for CD117, scattered large neoplastic spindle cells (less than 1% of tumor cells) in two intestinal leiomyosarcomas showed strong cytoplasmic positivity; these four tumors were negative for CD34.

Ref https://www.nature.com/articles/3880210