Upper Gastrointestinal Surgery Flashcards
What surveillance is offered in Barrett’s oesophagus?
2-5 yearly OGDs
Name a drug that can be used in diabetic gastroparesis
Erythomycin
Name three infections that can cause sclerosing cholangitis
CMV
Cryptosporidium
Microsporia
Which inherited condition is associated with insulinomas?
MEN 1
List the triad of insulinoma
Symptomatic hypoglycaemia during fasting
Hypoglycaemia
Relief of hypoglycaemia with use of glucose
What is the advantage of NJ over NG?
Prevents feed pooling in stomach which risks aspiration
Which operation is used to resect proximal oesophageal tumours?
McKeown oesophagectomy
Which operation is used to resect middle and distal oesophageal tumours?
Ivor Lewis oesophagectomy
What treatment before surgery improves survival in oesophageal cancer?
Chemotherapy
Where is oesophageal rupture most common?
Left postero-lateral - 2-3cm from OG junction
Which malignancy is associated with Barrett’s oesophagus?
Adenocarcinoma of the oesophagus
Where does pancreatic cancer commonly metastasis?
Liver
What causes pain in advanced pancreatic cancer?
Invasion of the coeliac plexus
Which operation can be performed for very distal oesphageal cancers?
Transhiatal resection
What is the most common cause of major haemorrhage in the duodenum?
Posteriorly sited duodenal ulcer
What is the Rockall score used for?
To determine the risk of rebleed and mortality following endoscopy for UGIB
What is the Glasgow Blatchford score used for?
To determine the need for admission in UGIB and the timing of OGD
Which inherited disorder is associated with gastrinomas?
MEN 1
Where do patients with Zollinger-Elison syndrome get ulcers?
Duodenum or jejunum
What are the boundaries of the gastrinoma triangle?
Junction of cystic duct and CBD
Junction of D2 and D3
Junction of neck and body of pancreas
Which hormone suppresses gastrin secretion?
Secretin
Which artery is compromised by a posterior duodenal ulcer?
Gastroduodenal ulcer
What causes achalasia?
Progressive degeneration of ganglion cells in the myenteric plexus in the oesophageal wall, leading to failure of relaxation of the lower oesophageal sphincter (LES), accompanied by a loss of peristalsis in the distal oesophagus
Which structure is frequently divided to allow mobilisation in an oesophagectomy?
Azygous vein
Which type of cancer is associated with achalasia?
SCC oesophagus
What is the most common cell of origin in pancreatic cancer?
Ductal
