Gastro/general surgery

Question 1

What are the features of a hydatid cyst?

Answer 1

Eosinophilia and abnormal LFT’s
Intense fibrotic reaction around sites of infection
The cyst has no epithelial lining
Pt’s present with malaise and right upper quadrant pain
US may show septa or daughter cysts

Question 2

What is the management for a hydatid cyst?

Answer 2

Mebendazole
May be followed by surgical resection - cyst site is packed with gauze soaked in hypertonic saline

Question 3

Features of a liver haemangioma?

Answer 3

Often hyperechoic on US
Most common benign tumours of mesenchymal origin

Question 4

Features of a liver cell adenoma?

Answer 4

90% of cases develop in women between their 3rd and 5th decade
Linked to COCP use
Usually solitary in origin
If patients have haemorrhage or symptoms, surgical removal MAY be required.

Question 5

Features of a liver abscess?

Answer 5

biliary sepsis is a major predisposing factor
Symptoms include fever and right upper quadrant pain
Jaundice may be seen in 50% of patients.
US will show a fluid filled cavity, hyperechoic walls may be seen in chronic abscesses

Question 6

What is Mirrizi syndrome?

Answer 6

A rare complication where a gallstone becomes impacted in the cystic duct causing compression to the common hepatic duct resulting in obstruction and jaundice.

Question 7

What are the contents of the porta hepatis?

Answer 7

the bile duct, hepatic artery and portal vein (from superficial to deep)