Esophagus Perforation

Q) Elderly healthy male with impacted denture. Removed endoscopically. Pt developed fever, dyspnoea and respiratory distress over 24 hrs. X-ray revealed Lt hydrothorax and mediastinal emphysema.

a) ICD and NG feeds

b) ICD and TPN

c) Cervical esophagectomy, FJ, debridement, ICD

d) Debridement, primary repair with buttress and ICD

Premium answer

Fowler Stephen Surgery

Q) Fowler Stephen Surgery is done for 

a) Epispadias

b) Hypospadias

c) Exstrophy of bladder

d) Cryptorchidism

Answer Free for all 

d) Cryptorchidism

Surgeries for Epispadias are - 

Exstrophy 

1. MSRE- Modern stage repair of Exstrophy includes bladder closure, pelvic osteotomies followed by epispadis repair and uretheroplasty at 12-18 months

 Young-Dees-Leadbetter repair- Bladder neck reconstruction for exstrophy

 Kelly repair (RSTM) Radical soft tissue mobilization

2.  Complete primary repair for classic bladder exstrophy (CPRE) 

Cryptorchidism - Fowler stephens surgery means division of short testicular vessels to mobilise the testis

The testicular blood supply is then dependent on collaterals from the vasal artery.

 

 

 

Treatment of anal incontinence


Q) Newest treatment for anal incontinence?
a. Sacral nerve stimulation
b. Artificial sphincter.
c. Repair of sphincter
d. Gluteus maximus graft

More Questions 

Answer a)

Sacral nerve stimulation is the newest modality in treatment for anal incontinence. In it electrodes are placed via the sacral foramina. The nerve supply of anal sphincter is similar to lower extremity so their stimulation can lead to contraction of various foot muscles.

Others are all older methods

Shackelford page 1779

Cholecystostomy

Q.    Regarding percutaneous cholecystostomy A/E

a.       Technical success in 90 – 98 % of cases

b.      Indicated in Grade II cholecystitis with significant pericholecystic inflammation & GOO

c.       Indicated in Gr III cholecystitis with significant comorbidity

d.      In Grade III cholecystitis with biliary peritonitis, PCC results in significant improvement

Answer