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Blood Supply of Stomach

Q) True about blood supply of stomach

a) Right gastric artery is the largest artery to the stomach

b) At least three out of four arteries of the stomach can be ligated and blood supply to the stomach may remain preserved.

c) Right gastric artery originates from splenic artery

d) Aberrant left hepatic artery arises from splenic artery

Answer

b

Blood supply of stomach is mostly consistent and there are four named arteries.

Left gastric artery is the largest artery to the stomach and in 15-20% cases, there is an aberrant left hepatic artery which arises from it. 

At least three arteries of the stomach can be safely ligated if the arcades on the greater and lesser curvatures are preserved and vascularity of whole of stomach may be preserved.

Right gastric artery is the branch of common hepatic artery or Gastro duodenal artery

Aberrant left hepatic artery is the branch of Left gastric artery. It is seen in 15-20% cases.

Right gastro epiploic artery is the branch of Gastro duodenal artery and left gastro epiploic from splenic artery

Blood supply of stomach

 

GI Bleed

Q )  A 59 year old male alcoholic male presents with history of upper GI bleed of 1 day duration. During the day he has had three episodes of bleeding each time about 150 ml. Blood is fresh and not associated with retching. He has a history of long standing alcohol intake. What will be the most likely cause of GI bleed

a) Mallory weiss tear

b) Esophageal varices

c) Gastric ulcer

d) Esophagitis

Answer for premium

Median arcuate syndrome

Q) Median arcuate syndrome is due to compression of 

a) Coeliac artery

b) Superior mesenteric artery

c) Phrenic artery

d) Inferior mesenteric artery

Free Answer for MCH GI Surgery Questions

A) a

Median arcuate syndrome is also known as coeliac artery compression syndrome. Median arcuate

ligament connects the diaphragm with the spine. In some individuals this median arcuate compresses the coeliac artery and produes abdominal pain. Read More ...

Mass in Right lower quadrant

Q) A 55 year old lady presents with vague pain in right lower abdomen. Physical examination reveals a well defined mass there which is non tender and freely mobile. It is non pulsatile as well. What is the most likely possibility?

a) Appendicular mass

b) Mesenteric cyst

c) Perforated tubo ovarian mass

d) Meckel's diverticulum

Answer

b

Mesenteric cysts are uncommon lesions found in this age group. It typically presents as a freely mobile mass  which moves perpendicular to small blwel axis. It is painless as well.

Appendicular mass will have a preceding history of pain abdomen

Similarly perforated  tubo ovarian mass will also have a history of pain 

Meckel's diverticulum does not present as this kind of mass

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