Lymph node stations in Carcinoma stomach

by

Q) In gastric cancer, lymph node station 12 corresponds to 

a) Common hepatic

b) Hepatoduodenal

c) Retropancreatic

d) Superior Mesenteric

Ans b

In gastric cancer, lymph node station 12 corresponds to the hepatoduodenal ligament lymph nodes.  These nodes are specifically located along the hepatoduodenal ligament and are further subdivided into groups based on their anatomical relationship: along the hepatic artery (12a), along the bile duct (12b), and behind the portal vein (12p)

Altemeier procedure

by

Q) True about altemeier procedure?

a) It is proctosigmoidectomy with posterior levataroplasty

b) Done in left lateral position

c) Recurrence rate can be as high as 50%

d) Altemeier was the 1st person to do it

Ans a

The Altemeier procedure, also known as perineal rectosigmoidectomy, is a surgical technique used to treat rectal prolapse.

Altemeier procedure is a perineal surgical procedure in moribund and old patients.

It combines proctosigmoidectomy with posterior  levatorplasty.

A disadvantage of the perineal proctosigmoidectomy is the increased recurrence rates of
12% to 24% compared with the abdominal approach.

It is done in prone jack- knife position It was initiated by Mikulicz in 1899 and popularized by Altemeier in 1920s

Hydatid liver

by

Q) Not an indication of surgery in hydatid cyst liver

a) CE2 cyst with multiple daughter cysts

b) Large 10 cm cyst situated peripherally

c) Infected cyst

d) 6 cm asymptomatic cyst

All the following would be seen after splenectomy for hereditary spherocytosis except?

by

a) Persistence of spherocytosis

b) Anemia

c) Same osmotic fragility

d) Normal life span of erythrocytes

Answer for all members

Primary Sclerosing Cholangitis

by

Q) Which is not an indication of liver transplantation in primary sclerosing cholangitis?

a) Intractable pruritis

b) Recurrent episodes of cholangitis

c) Cholangiocarcinoma

d) Dominant stricture

Esophageal hiatus hernia

by
Type III Hiatal Hernia MCQ for NEET SS | mcqsurgery.com

What is a Type III esophageal (hiatal) hernia?

Correct Answer

c) Combination of sliding and paraesophageal hernia

Explanation

Hiatal hernias are classified based on the position of the gastroesophageal junction and stomach. Type I involves upward displacement of the GEJ into the thorax. Type II has a normally positioned GEJ with part of the stomach herniating alongside the esophagus. Type III is a mixed hernia where both the GEJ and stomach herniate into the thoracic cavity. Option (d) is more consistent with a giant paraesophageal hernia (Type IV).

Teaching Points

  • Type I is the most common and associated with GERD
  • Type III is a mixed hernia involving GEJ and stomach
  • Type II and III have higher risk of volvulus and strangulation
  • Large hernias with most of the stomach in chest are Type IV
Free Questions Mock Tests Join Premium Surgery Course

Q Most common urological complication in Crohn’s disease is

by

a) Ureteral obstruction

b) Entero vesical fistula

c) Pyonephrosis

d) Recto uretheral fistula

Answer Premium

 

Hemangioma Liver

by
Hepatic Hemangioma Management MCQ for NEET SS | mcqsurgery.com

A 38-year-old woman is found to have a 12-cm hepatic hemangioma. Which statement regarding management is true?

Correct Answer

d) If surgery is planned, peripherally located hemangiomas should be enucleated

Explanation

Hepatic hemangiomas are the most common benign tumors of the liver and are usually detected incidentally. Management depends on symptoms, complications, and diagnostic certainty, not size alone.

  • Size and surgery:
    Lesion size alone, even when greater than 10 cm (giant hemangioma), is not an indication for surgery if the patient is asymptomatic.
  • Oral contraceptives and pregnancy:
    Although estrogen exposure may cause hemangioma enlargement, there is no strong evidence that oral contraceptive pills or pregnancy significantly increase the risk of rupture. Routine avoidance is not recommended.
  • Role of arterial embolization:
    Arterial embolization is not performed routinely. It is reserved for:
    • Symptomatic patients unfit for surgery
    • Acute bleeding
    • Preoperative reduction of tumor vascularity
  • Surgical technique:
    When surgery is indicated (symptoms, complications, or diagnostic uncertainty), enucleation is preferred for peripherally located hemangiomas because it:
    • Preserves maximum liver parenchyma
    • Results in less blood loss
    • Has lower morbidity compared to formal hepatic resection

Teaching Points

  • Hepatic hemangioma is the most common benign liver tumor
  • Size alone is not an indication for surgery
  • Most asymptomatic hemangiomas require only observation
  • Enucleation is preferred over resection when surgery is needed
  • Embolization is reserved for selected symptomatic or high-risk cases
Free Questions Mock Tests Join Premium Surgery Course

Complications of Billroth II surgery

by
Billroth 1 and 2
Complications of Billroth II Surgery – Free MCQ | mcqsurgery.com

Complications of Billroth II – Free MCQ (GI Surgery)

High-yield stomach surgery question for NEET SS & GI Surgery preparation. Use the Answer Free button to reveal the explanation.

Q) What is true regarding complications of Billroth II surgery?

a) It has less complications than Billroth I surgery
b) Recurrent ulceration is more common in the afferent limb as compared to efferent limb.
c) Afferent loop obstruction is more common after Billroth II  surgery
d) Billroth I  operation is preferred in scarred duodenum

Answer c -

In Billroth II surgery, afferent limb obstruction is more common

In Billroth I reconstruction The remnant is anastomosed  to the duodenum

In Billroth II duodenum stump is closed and stomach is anastomosed to the jejunum limb

Advantages of Billroth I

  • More Physiological as normal GI continuity is maintained
  • No problem of afferent and efferent limb
  • Future procedures like endoscopy and ERCP can be done
  • Reduced chance of gastric carcinoma in remnant stomach as compared to Billroth 2  ( SKF page 682) 

In surgery for benign gastric ulcers, Billroth I reconstruction is the preferred choice.

Billroth II surgery has problems of

  • Retained antrum syndrome
  • Afferent loop obstruction
  • Duodenal stump leak (1-3%

Billroth 2 surgery is done when there is

1. Inadequate mobility of the duodenum

2. Scarring of duodenum

Complications of gastric surgery
Complications of gastrectomy

  • Nutritional and weight loss - Iron deficiency, Copper deficiency, Vit B12 , Anemia
  • Delayed gastric emptying
  • Roux statsis- Seen in roux en y loops-  Pain, nausea, vomiting, abdominal bloating
  • Cholelithiasis-  Higher incidence in roux en y reconstruction as compared to B1 and B 2 gastrectomy
  • Recurrent ulceration

Complications of Billroth 2 surgery

  • Dumping syndrome Dumping symptoms have been reported in up to 70% of Billroth II patients and up to 75% of patients after RYGBP for obesity.
  • Afferent loop obstruction - It can be minimized by keeping the length of afferent loop less than 20 cm and using a retrocloic approach.
  • Bile reflux gastritis - More common with billroth I and billroth 2 surgery, incidence is decreasing after the use roux en y anastomosis
More Questions on Stomach GI Surgery Question bank
Join Premium Surgery Course
← Free Question Stomach Mcqs →

Tags: Billroth I, Billroth II, Afferent loop obstruction, Stomach Surgery MCQ, NEET SS GI Surgery