Blood supply of CBD

by

Q) Supraduodenal  CBD is supplied by all except (AIIMS NOV 18)
a Cystic art
b RHA
c LHA
d Anterosuperior pancreaticoduodenal artery

Ans c

The blood supply to the right and left hepatic ducts and upper portion of the CHD is from the CA and the right and left hepatic arteries.

The supraduodenal bile duct is supplied by arterial branches from the right hepatic, cystic, posterior superior pancreaticoduodenal, and retroduodenal arteries.

arteries to the supraduodenal bile duct run parallel to the duct at the 3 and 9 o’clock positions.

Approximately 60% of the blood supply to the supraduodenal bile duct originates
inferiorly from the pancreaticoduodenal and retroduodenal arteries

whereas 38% of the blood supply originates superiorly from the right hepatic artery and CD artery

Bible of GI Surgery for AIIMS. Get your own Kindle Edition 

GI bleed

by

Q) Which of the following statement is incorrect for  GI bleeding?

a) Clear nasogastric aspirate rules out Upper gi bleed

b) RBC scan detects bleed upto 0.1-0.5 ml/min

c) Angio detects 0.5-1 ml/min

d) UGI bleed is responsible for 15% of haematochezia

Answer

Complications of Meckel’s diverticulum

by

Q. Least common complication of Meckel's diverticulum is 

a) Bleeding

b) Obstruction

c) Neoplasm

d) Obstruction

While many individuals remain asymptomatic, complications of Meckel's diverticulum can lead to significant clinical issues requiring medical intervention.

Answer is free 

Ans ) c Neoplasm

The most common clinical presentation of Meckel’s diverticulum is gastrointestinal bleeding, which occurs in 25% to 50% of patients who present with complications.

Bleeding is  often due to ulceration of the diverticulum. This bleeding can manifest as painless rectal bleeding

Another potential complication is intestinal obstruction, which can occur if the diverticulum becomes incarcerated or twisted. This situation may lead to bowel ischemia and perforation if not managed quickly.

Intestinal obstruction occur as a result of a volvulus of the small bowel around a diverticulum associated with a fibrotic band attached to the abdominal wall, intussusception, or, rarely, incarceration of the diverticulum in an inguinal hernia (Littre hernia)

Diverticulitis accounts for 10% to 20% of symptomatic presentations.

Neoplasms can also occur in a Meckel’s diverticulum, with NET as the most common malignant neoplasm (77%). Other histologic types include adenocarcinoma (11%), which generally originates from the gastric mucosa, and GIST (10%) and lymphoma (1%).

Complications of Meckel's diverticulum can be recognised and managed early if there is high index of suspicion

Complications of Meckels diverticulum