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 esophagus, 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

 

Bariatric Surgery

Q)  False regarding Bariatric surgery

a) VBG produces less weight loss when compared to RYGB

b) Jejuno-ileal by-pass not done nowadays.

c) Dumping is due to non- compliance of dietary advice

d) LAGB requires once a 4-6wk follow up

Answer (free)

c
Calorie restriction is responsible for long term weight loss and its beneficial effects such as control of diabetes, dyslipidemia, hypertension and other metabolic abnormalities.
Restrictive procedures are LSG and  LAGB  which decrease the appetite and induce early satiety.           
The RYGB (ROUX en Y  gastric bypass ) is  a malabsorptive procedure  with long term sustained weight loss.
Mechanism of weight loss after bariatric surgery
Ghrelin is orexigenic gut hormone, which increases appetite. After food intake ghrelin levels fall and appetite decreases.
After restrictive surgery such as LYGB and LSG, ghrelin levels fall and appetite decreases.
Vertical Banded Gastroplasty (VBG) This procedure has been abandoned in favor of other operations because of poor long-term weight loss, a high rate of late stenosis of the gastric outlet, and a tendency for patients to adopt a highcalorie liquid diet, thereby leading to regain of weight. Choice a is correct

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Roux stasis

Q) True about Roux stasis syndrome

a) Dilated Roux limb present

b) can be prevented by inter positioning 20 cm jejunum between stomach n duodenum

c) Delayed gastric emptying of solids

d) It is not related to the size of gastric remnant

Answer

In Roux stasis syndrome there is abnormal peristalsis in the roux limb and propulsion  is proximal. Read on