Q) Which of the following is a Perineal procedure in rectal prolapse
A. Delorme
B. Ripstein
C. Resection rectopexy
D. Frykman Goldberg procedure
FAP
Q) Which of the following is a type of Familial Adenomatous Polyposis
A. Garderner syndrome
B. PJS
C. Juvenille polyps
D. Hamartomatous polyp
Neuroendocrine tumors
Q) DVT, Depression, Dermatitis, Diarrhoea seen in
A. Glucagonoma
B. VIPoma
C. Somatostatinoma
D. Gastrinoma
Association of WDHA syndrome
Q. WDHA syndrome is associated with
A. VIPoma
B. Somatostatinoma
C. Glucagonoma
D. Gastrinoma
Difference between Ulcerative colitis and Crohn disease
Q. Not seen in ulcerative colitis?
a) Anal fistula
b) Association with primary sclerosing cholangitis
c) Superficial epithelial involvement
d) Backwash ilieitis
Classification of Choledochal cyst
Q) Choledochocele is type
A. 2
B. 3
C. 4
D. 5
Todani Classification of Alonso Lez Modification in Choledochal cyst
We discuss
- Classification system
- Percentage of each
- Management of all types of choledochal cyst
Retained antrum syndrome
Q. True about retained antrum syndrome after gastrectomy are all except?
Correct Answer
c) Technetium labelled food is not helpful in diagnosing this condition
Explanation
After billroth II gastrectomy, if a cuff of gastric mucosa remains with duodenum, this entity is called as retained antrum syndrome. This cuff of gastric mucosa is cut off from the proximal stomach and inhibitory effect of hormones such as VIP (Vasoactive Intestinal Peptide) leading to a persistent hypergastrinemic state. ALso this gastric mucosa is continuously bathed by the alkaline contents of duodenum , which further increases the acid formation.
Both Basal and maximal gastric acid outputs increase but it is not as high as seen in zollinger ellison syndrome. Typically less than 1000 pg/ml
This condition can present as recurrent and persistent ulcerations. Technetium scanning is the diagnostic modality of choice. Treatment is re do surgery and antral excision.
Technetium pertechnate imaging has a sensitivity of 73% and specificity of 100%
Teaching Points
- Retained antrum syndrome occurs due to incomplete antrectomy, commonly after Billroth II gastrectomy.
- Loss of inhibitory hormonal control leads to persistent hypergastrinemia.
- Serum gastrin levels are elevated but usually <1000 pg/ml.
- Presents with recurrent or refractory peptic ulcer disease.
- Technetium pertechnate scan is the investigation of choice.
- Definitive treatment is redo surgery with excision of retained antrum.
More about retained antrum syndrome
Duplication of intestine
Q) Duplication of the intestine associated with
A. Heterotopic mucosa
B. Smooth muscle component
C. Associated with spinal / vertebral defects
D. All are correct
Meckel’s diverticulum
Q Meckel’s diverticulum true is
A. Mc congenital anomaly of the intestine
B. Always heterotopic mucosa
C. Pseudodiverticula
D. Located on mesenteric border
Colonic diverticulitis
Q . Best investigation to diagnose Colonic diverticulitis
A. Ba enema
B. CT scan
C. USG
D. MRI