Q) An young male with cholangitis, EHPVO + Portal Biliopathy was drained with a plastic biliary stent next step?
a) Repeat biliary Stenting every 3 months then followed up
b) Replace plastic to bare metal stent
c) Prepare for Lineorenal shunt surgery
d) Do MRCP and proceed accordingly
Points about Portal Biliopathy
Portal biliopathy (PB) is a clinical condition defined as the presence of abnormalities in the biliary tree (including biliary tree and gallbladder) in patients with non-cirrhotic/non-neoplastic extrahepatic portal vein obstruction (EHPVO) and portal cavernoma.
The spectrum of biliary abnormalities include both intra- and extra-hepatic biliary stenosis (single or multiple)
With or without consensual above dilation
Bile duct wall irregularity or thickening
Bile duct angulation
Varicose veins located at the ductular walls and gallbladder
Q) Small intestine diverticula true statement is a. Meckel is Most common and jejuno ileal is least common but most symptomatic b. Meckel is true and congenital and rest are false and acquired c. 1-5 % Duodenal ones require endoscopic or surgical treatment d. All Meckel’s resected unless strong Contraindication is there