Q5. What is not true regarding Cholangiocarcinoma?
a) Intrahepatic cholangiocarcinoma is the least common type anatomically
b) Primary resection is the main treatment
c) Liver Transplant is the main treatment
d) A multidisciplinary team should evaluate and manage all patients of cholangiocarcinoma
Most common cause of gastric varices is portal hypertension followed by splenic vein thrombosis. Gastric varices are of two types 1.
Gastroesophageal varices and 2. Isolated Gastric varices (IGV) .
IGV are further subclassified into Type 1. Fundic gastric varices in the fundus and Type 2 Ectopic, anywhere in the stomach except fundus.
Incidence of bleeding in gastric varices is 3-30% and not 70%. If the cause of gastric varices is portal hypertension, eradication of esophageal varices leads to eradication of gastric varices also. other treatment options are banding, glue, TIPS and liver transplant.Sclerotherapy is not preferred because of ulcer formation which can cause recurrent bleeding.
Patients with rectal prolapse have specific anatomic and physiologic characterstics. The anatomic characterstics include deep and not shallow pelvic cul de sac along with patulous anal sphincter, redundant sigmoid colon, diastasis of levator ani and loss of sacral attachments.
Esophgeal atresia is commonly associated with VACTER defects (Vertebral, Anal, cardiac, Tracheobronchial, esophagus, radial). It is associated with choking and excessive salivation on attempting 1st feed. Nasogastric tube is seen to be coiled up in upper chest on Xrays. It
Haematogenous route is the most common route for acquiring splenic abscess (70%). Risk factors inculde polycythemia vera, malignancies, IV drugs etc. Unilocular splenic abscess has mortality rates of 15-20% and multiloculated abscess about 80%. Typical symptoms are fever, pain abdomen, pleuritic chest pain. Splenomegaly is uncommon.