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

Management of GERD

Q. 40 yr old lady with symptoms of GERD. Endoscopy shows hiatus hernia. Symptoms controlled with PPI. Next step

a) Leave alone

b) Manometry with Ph study

c) Ba swallow with Manometry

d) Ba swallow with Ph study

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

 

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.

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) 

 

 

 

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