Caustic Injury to esophagus

Q ) False regarding Caustic injury to Esophagus

a) Gastric lavage not done as it increases the chances of more injury

b) Neutralising  agents not given as it produces more injury than preventing it

c) Milk and albumin not given as it causes more damage

d) Activated charcoal not given as it doesn’t effectively absorb alkali

Check one more question on caustic injuries to esophagus here


Answer 

In  caustic injuries to the esophgaus, early decisions have to be taken. The involvement of surgeon should be done early and patient should be placed under close monitoring.

Blind nasogastric and orogastric tubes should not be inserted and initially CT of chest and abdomen with contrast should be done to guide the subsequent procedures. Read on

 

Pressure sore

Q) Pressure sore, grade II is

a) Partial thickness skin loss, epidermis and dermis are involved

b) Full thickness skin loss, involving subcutaneous tissue but not underlying fascia

c) Non blanchable erythema, no breach in epidermis

d) Involvement of bones and tendons


Ans a

Pressure sores occurs when ext pressure exceeds the capillary occlusive pressure (30 mmHg) approximately 5% of all hospitalised patients

Stage                   Description

1                        Non-blanchable erythema without a breach in the epidermis

2                       Partial-thickness skin loss involving the epidermis and dermis

3                       Full-thickness skin loss extending into the subcutaneous tissue but not through underlying fascia

4                        Full-thickness skin loss through fascia with extensive tissue destruction, maybe involving muscle, bone, tendon or joint

Bailey - page 29

 

Bile duct injuries in cholecystectomy

Q True about Bile duct injuries in cholecystectomy

a) Only 15% are recognized at the time of surgery

b)Routine  Operative cholangiography  definitely reduces the incidence of bile duct injury

c) In incomplete obstruction of bile duct,  jaundice occurs early

d) Surgical outcome depends on timing of surgery

Answer for premium members

After cholecystectomy complications can occur in 15%. Identification and management of bile duct injuries is very important. This question and subsequent discussion has been routinely asked in many exams

Siewert

  1. Q) False regarding CA Esophagus

    a) Siewert I treated as Esophageal cancer

    b) Siewert III treated as Gastric cancer

    c) Siewert II treated as Esophageal cancer or Merindino surgery

    d) Proximal margin in Esophagus is determined routinely to alter the management

    Answer

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