Caustic Injuries of Esophagus

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Q . Caustic injury of esophagus pick up the  false statement ( # All Questions of esophagus) 
a) Steroid is used 
b) Carcinoma risk  is 30%
c) Contrast study has false negative of 25%
d Esophageal stent reduce leaks by 75%

Ans ) a

Points of esophagus caustic injuries

There is no proven benefit of starting steroids in early or intermediate phase of injury as there is no evidence to support prevention of stricture

  1. Endoscopy should be performed after initial stabilization
  2. Complete esophagus can be examined now with flexible endoscopes
  3. Available studies show no benefit of steroid use ( skf PAGE 521) 
  4. Cancer risk is 30% in injured and non injured portions

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Risk factors Barrett

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Q).Risk factors  for Barrett esophagitis
a) Female
b) Obesity
c) Alcohol

d) 

Histopath of Caustic injuries

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Q. Which of the following is not a histologic feature  of acute phase in caustic injury of the esophagus?
a) Thrombosis
b)Liquefaction  Necrosis
c) Sloughing
d) Bacterial and lymphocyte infiltration

caustic esophagus injury

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Q) Caustic esophagus injury on endoscopy there is  Deep ulcer with black mucosa. Grade ?(# Aiims GI 2020) 
a) 2a
b) 2b
c) 3a
d) 4

Complications of conduit anastomosis after esophagectomy

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Q) False statement about site of esophagus anastomosis after esophagectomy? AIIMS Jun 2020 GI 

a) Reflux is more in cervical than mediastinal

b) Stricture rate is more with circular stapler anastomosis

c) Stomach preconditioning decreases leak rates

d) Injury to recurrent laryngeal nerve increases pulmonary complications?

Two field esophagectomy

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Q) WHIch group of lymph nodes not removed in two field Lymph node dissection in lower esophageal Carcinoma

a) Brachiocephalic

b) coeliac

c) left gastric

d) Lower mediastinal

Other Questions on Esophagus

Quesions 26-30

31-40

Q 41-50

Esophagus Lymphatics

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Q) Esophageal lymphatic- False is 
a. Lymphatics above tracheal bifurcation drain to sub-carinal, and mainly upwards 
b. EUS can access and samples many stations

c. 40 percent submucosal lymphatic drain to thoracic duct
d. T1a nd T2a  has similar lymph node inolvement

Colon conduit in Caustic injuries

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Q What is not true about the use Colon conduit for caustic injuries
a. Left colon is used  trans hiatally and anastomosed to  posterior wall of stomach
b.Order of anastomosis is  ColoGastric -Colo- Colic, Colo-Cervical
c. MCA and RCA always cut
d. Based on ascending LCA

Esophagus duplication cyst

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Q) False statement about esophagus duplication cyst

a) Cystic form is most common  which does not  communicate with the lumen

b) Adults are mostly asymptomatic

c) Malignnat transformation is rare

d) Most commonly seen in middle 1/3 of esophagus

 

prognostic factor for carcinoma esophagus

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Q. Most important prognostic factor for carcinoma esophagus is
 
a) Cellular differentiation                                 b) Depth of  esophagus involvement
 

c) length of  esophagus involvement            d)   age of the patient

Questions

b
Most important is depth of involvement of wall  of esophagus and lymph node involvement of the surrounding esophageal tissue.
 Length of esophagus involvement is not that important because esophagus has extensive submucosal lymph supply and for complete cure 10 cm excision margin would mean removal of almost total esophagus.