Gastric resections

Question 1

Jejunoileal anastomosis

Answer 1

Jejunum attached to iluem, resulting in transient gastric acid hypersecretion and impaired digestion

Question 2

jejunocolic anastomosis

Answer 2

Jejunum attached to colon - b12 deficiency, steatorrhoea, KEDA deficiency, choleretic diarhoea, bile salt reabsorption impaired

Question 3

Jejunostomy

Answer 3

significant nutrient and fluid losses, magnesium deficiency, b12 deficiency, impaired bile salt reabsorption

Question 4

Whipple procedure

Answer 4

Pancreaticduodenectomy, remove the head of the pancreas, duodenum, the gallbladder and the bile duct

Question 5

Hartmanns procedure

Answer 5

sigmoid colon and upper rectum removed and colostomy formed

Question 6

Early symptoms of resections

Answer 6

Dumping syndrome, small stomach syndrome, diarrhoea, bile vomiting,

Question 7

Vagotomy

Answer 7

Excision of vegus nerves typically to reduce gastric acid secretion to prevent further development of peptic ulcers

Question 8

Pyloroplasty

Answer 8

Widen pyloric sphincter to allow food to enter duodenum

Question 9

Long term consequences of gastrectomy

Answer 9

Weight loss and undernutrition
Malabsorption
Anaemias

Question 10

In cases of severe steatorrhoea, what could you substitute fat for?

Answer 10

glucose polymers or MCTs

Question 11

Medical management of malabsorption secondary to gastrectomy

Answer 11

anti-diarrhoeal, bile acid binders, pancreatic enzyme replacement

Question 12

Disturbances following disturbed gastric function

Answer 12

Dumping syndrome
increased intestinal motility
reduced pancreatic enzymes
reduced IF secretion
inadequate mixing of food
abolishment of normal pH gradient
reduced absorption