The patient has diverticular disease and not diverticulitis. Uncomplicated diverticular disease has no signs of obstruction, perforation and is managed with high fibre diet and increase in fluid intake.
Antibiotics are indicated in persistent left lower quadrant pain which is not relieved on passing stools
0.2-0.6 g of bile salts are secreted by liver each day in the form of cholic acid and dexoy cholic acid.
Only 5% of bile salt is excreted per day and 95% is absorbed by the portal vein
Bile is stored and concentrated in the gall bladder
Gall bladder fills by retrograde mechanism by contraction of sphincter of oddi.
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.
Epiphrenic diverticulum is a lower esophageal diverticulum with in 10 cm of gastro esopheal junction (GEJ) Most of these diverticula are secondary and false due to associated motor disease such as Diffuse esophageal spasm (DES) or Achlasia. (Read more about Achlasia Cardia here) Unlike the middle esophageal divertula these are not traction diverticula. These are most commonly seen on the right side.
Most of these are asymptomatic and treatment is required only if they cause chest pain (due to DES) or regurgitaion or aspiration.
Hello And Welcome to Surgery MCQs. These multiple choice questions in surgery are from various entrance exams. Answers and Explanations are provided for each question and references are also given. We hope you have a good time reading these and give your valuable inputs at our facebook page