GIT Surgery Flashcards
Rockall Score is done for
To asses mortality rate after an upper GIbleed following endoscopy
Blatchford score
The need for admission and timing of endoscopic intervention may be predicted by using the Blatchford score. This considers a patients Hb, serum urea, pulse rate and blood pressure.
If liver or renal failure then which Rockallscore isit
Score 3
Post gastrectomy syndrome
Post gastrectomy syndrome
Rapid emptying of food from stomach into the duodenum: diarrhoea, abdominal pain, hypoglycaemia
Complications: Vitamin B12 and iron malabsorption, osteoporosis
Treatment: High protein, low carbohydrate diet. Replace B12/Fe/Ca
individuals who have undergone truncal vagotomy will tend to routinely require
her a pyloroplasty or gastro-enterostomy as they would otherwise have delayed gastric emptying.
Gastric emptying hormonal factors
Delay emptying
1Gastric inhibitory peptide
2Cholecystokinin
3Enteroglucagon
Increase emptyin
Gastrin
Pyloroplasty should not be performed in the presence of?
Pyloroplasty should not be performed in the presence of fibrosed and scarred pyloroduodenum in chronic duodenal ulcer.
Pro kineticc for gastro paresis is
Erythromycin
Congenital Hypertrophic Pyloric Stenosis
infancy around 6 weeks of age
hypochloraemic metabolic alkalosis
most important diagnostic test is an ultrasound
The most important diagnostic test for congenital Hypertrophic Pyloric Stenosis
Ultrasound
What Kind of surgery in distal gastric ulcer malignancy
gastroenterostomies constructed for bypass of malignancy are usually placed on the anterior wall of the stomach (in spite of the fact that they empty less well).
What does signet ring cell represents in gastric cancer
Signet ring cells are features of poorly differentiated gastric cancer associated with a increased risk of metastatic disease.
Billroth surgery
Billroth I gastrectomy. The lower half of the stomach is removed and the cut stomach anastomosed to the first part of the duodenum.
Billroth II. Two-thirds of the stomach is removed, the duodenal stump is closed and the stomach anastomosed to the jejunum.
What is Gastroenterostmy
Gastroenterostomy. The jejunum is anastomosed to the posterior, dependent, wall of the stomach.
Bormann Classification
4types for gastriccancer
Polypoid
fungating
Ulcerated
Flat
1st two are lowgrade and other two are highgrade
Relation of signet ceL L with stomach Ca
More signet cells means high grade Gastric ca
Troisier’s sign).
This may be extensive, the tumour even appearing in the supraclavicular nodes (Troisier’s sign).
Radical Total Gastrectomy
Radical total gastrectomy: (a) dissection of omentum off the transverse colon; (b) exposure of the lesser sac; (c) splenectomy; (d) division and oversewing of the duodenum; (e) dissection of the left gastric artery nodes (group 17); (f) mobilisation of the oesophagus.
which surgery is most strongly associated with delayed gastric emptying?
Anterior gastro jejunostomy causes more delayed gastric emptying
What to do if vagotony is doneduring a gastric resection
surgery to disrupt or bypass the pylorus was often needed. These procedures comprised pyloroplasty and gastro-jejunostomy respectively.
why metaclopromide is notgiven to enhance gastric emptying after vegotomy
Metoclopramide increases the rate of gastric emptying but its effects are mediated via the vagus nerve
How Erythromycin enhances gastric emptying
Erythromycin enhances gastric emptying by acting via the motilin receptor in the gut.
What is McKeown procedure
McKeown procedure is a total oesophagectomy.
CA 19-9 is the maker for
Pancreatic cancer
Which Kind of lung cancer occurs in nonsmokers
Adenocarcinomas are the most common tumour type present in never smokers. They are usually located at the periphery.
Fibrosis in upper GI endoscopy indicates
Fibrosis is usually a sign of chronic ulcer. It should be biopsied carefully, a proton pump inhibitor started and re endoscopy should occur at 6 weeks.
Improve
upper GI endoscopy, a linitis plastica lesionShows
During upper GI endoscopy, a linitis plastica lesion may prevent gastric distension
Most Diagnostic sign of acute cholecystitis on Ultrasound
Sonographic Murphy’s Sign(primary finding)
Secondary finding of acute cholecystitis on Ultrasound
Pericholecystic fluid
Biliary sludge
GB wall thickness>3mm
Boerhave syndrome surgery
Thoracotomy with lavage if <12 hours
T tibe if >12 hours
