Anatomy

Question 1

LO: Surgical anatomy of GIT including: stomach,

Common surgical conditions involving the stomach? What symptoms may be described?

Answer 1

Hiatal hernias: sliding (more common, signs of reflux- regurgitation, heart burn, oesophageal changes) and paraoesophageal (more serious, can get volvulus)
Helicobacter ulcers, usually in the antrum- removed (partial gastrectomy)

Question 2

LO: Surgical anatomy of the anterior abdominal wall

Answer 2

To correct heniae
Ventral: usually incisional (post sx)
Inguinal: usually males. Indirect- tend to involve peritoneal contents, and be lateral to epigastric vessels. Direct- tend to just be a bulge (rather than protrusion of contents?), med to epi vessels?
Femoral: more serious, more common in females due to the wider pelvis

Question 3

What are some common clinical conditions of the oesophagus?

Answer 3

Hiatus hernia
(Barrett’s oesophagus)
Achalasia- decreased motility, sometimes the lower oesophageal sphincter is cut to facilitate passage of ingesta

Question 4

duodenum: conditions/complications, approaches?

Answer 4

Peptic ulcers, can get erosion of the gastroduodenal a (can be fixed laprascopically) and perforation/peritonitis
May be used to access ampulla laproscopically to assess for bile stones and pancreatic cancer.

Question 5

gall bladder: common conditions/sx approach?

Answer 5

Stones in 1/4 ppl, 1/2 of those will get clinical signs
Occasionally polyps
Laproscopically corrected. Do operative cholangiogram to check anatomy as lots of variation (only classic in 55% of ppl). Enter via ampulla?

Question 6

liver: anatomy?

Answer 6

2 functional lobes, about the gall bladder, supplied by L and R hepatic a?
Further divided into 8 segments

Question 7

small intestine: common surgical conditions? Utility?

Answer 7

Obstruction, adhesions, herniae, volvulus
Meckel’s diverticula (in 2% of ppl, occasionally cause problems
Ileal crohn’s disease (latter 2 both dz. of young adults and usually ileum)
Ileal pouch operation following large bowel resection

Question 8

appendix: condition/key points?

Answer 8

Sx resection in 1/6-8ppl (us under 40yrs)

Acute appendicitis. Usually intraabdominal location but can have variations

Question 9

colon and rectum: common surgical conditions?

Answer 9

Colorectal cancer= most common reason for large bowel sx. 1/20 ppl get it
Diverticular disease (can cause rectal bleeding) of colon
Ulcerative colitis and crohn’s colitis: predispose to colon cancer
Sigmoid colon volvulus: excise it
Rectal prolapse: more common in older, women