Complications of Whipple’s operation
Q) Most common complication after Whipple's operation is
a) Delayed gastric emptying
b) Pneumonia
c) Wound infection
d) Pancreaticojejunostomy leak
Answer for premium only - We discuss the percentage wise risk of complications.
Q) 75 year old man complains of obstipation for 2 days. He has taken laxatives but continues to have worsening pain and distension associated with vomiting. He underwent b/l knee replacement 2 weeks back. He was on Inj fentanyl for pain control. He is on antihypertensives and lipid lowering agents for the past 15 years.
On examination he is afebrile, oriented, pulse rate of 100 min/, BP 120/60 and abdomen is distended with mild tenderness. There are no signs of peritonitis, bowel sounds are sluggish.
TLC is 6,500, and potassium is 3.2 . All other blood tests are normal. X ray abdomen and CT abdomen shows dilated large bowel loops and oral contrast upto splenic flexure.
What is the probable diagnosis
a) Ischemic colitis
b) CMV colitis
c) Colonic Pseudoobstruction
d) Caecal volvulus
Aortic rupture
Q) Most common site for traumatic aortic rupture is
a) Distal to the origin of left subclavian artery
b) Point of entry of aorta above the diaphragm
c) Root of aorta
d) Point distal to Left carotid artery
Answer
a) Distal to origin of subclavian artery
Traumatic aortic rupture leads to sudden death after high impact automobile accident or fall from height. Aorta is relatively fixed distal to ligament arteriosum just distal to the origin of subclavian artery and this is the most common site of traumatic rupture especially partial rupture in which adventitia is intact.
Specific clinical findings are
- Asymmetry of BP in upper limbs or upper and lower limbs
- Widened pulse pressure
- Chest wall contusions
Bailey page 355
http://www.msdmanuals.com/professional/injuries-poisoning/thoracic-trauma/aortic-disruption-traumatic
Death in Crohn Disease
Q. Which of the following is the most common cause of death in Crohn's disease of small intestine
a) Malignancy
b) Sepsis
c) Electrolyte Disorders
d) Thromboembolic Phenomenon