Caustic injuries esophagus

 Medical questions on esophagus

Esophagus MCQ                  Questions 6-10                         Questions 11-15              Questions 21-25
Q16 Which of the following is not true about reconstruction in caustic injuries to esophagus
a) Caustic injuries to esophagus have 1000 times more risk of developing malignancy
b) Right colon replacement is definately better than left colon
c) The only indication for surgery is refractory strictures and possibility of malignancy
d) Most of the surgeons prefer bypass over resection of esophagus
Q17) CT Scan in Carcinoma Esophagus is least useful in describing
a) T staging
b) Nodal staging
c) Distant Metastasis
d) Omental involvement
Q18 . Barrett's esophagus is a premalignant condition. Which of  the following statement is false regarding Barrett's esophagus
a) Barrett's mucosa predisposes to Squamous cell carcinoma of esophagus
b) Risk of Cancer is 0.5% per year
c) Prevalence of Barrett's esophagus in general  population is  2-7%
d) Intestinal type of mucosa  with goblet cells is the most  common histopathological finding
 Q19)  Which of the following statement is true for epiphrenic diverticulum
a) Surgery or Endoscopic Intervention is required in almost all cases at detection
b) Most of these diverticulum of esophagus are primary
c) Most of the epiphrenic diverticula are on the right
d) These are also known as traction or mid esophageal divertcula
  Q20 ) One of the following is not a criteria of malignancy in lymph node on EUS

a) Size more than 1 cm

b) Prominent intranodal vasculature

c) Sharp well defined  borders

d) Hypoechoic 


                                        Answers to Esophagus Questions

16. b
There are no trials which determine that use of right colon is better than the left. In the absence of clinical trial choice of conduit depends on vascularity and surgeon's preference. Although the risk of developing malinancy is 1000 times high but in most large series involving 500-1000 patients only 1 or 2 patients developed cancer over a period of 20-30 years.
The risk of resecting the esophagus in badly adherent mediastinum is high so most of the surgeons opt for retro sternal bypass and not esophageal resection. The disadvantage of this approach is that it sometime converts the esophagus into a mucocele which can cause pain and mediastinal compression later on.