Highly selective vagotomy

Q) False about highly selective vagotomy
a) Highly selective vagotomy divides the vagus nerves supplying the acid-producing portion of the stomach
b) Incidence of postoperative complications is lower.
c) The criminal nerve of Grassi should be severed
d) Crow's feet nerves are severed till below the GE junction

 

 Ans -d

HSV only divides the last part of the nerves which supply the part of stomach which produces acid
Acnt and post nerves of Latarjet are found and their terminal branches are severed from 7 cm proximal to the pylorus to 5 cm above the GE junction
Motor function of the stomach is not affected
Criminal nerve of grassi is branch of posterior vagus. It should be sought and cut
Ref sab 2oth page 1206

Acute Gastric dilatation

Q) Not true about acute gastric dilatation (AGD) 

a) AGD is encountered most often as a postoperative complication in abdominal surgery 

b)Also seen in other  disorders, such as anorexia and bulimia nervosa, psychogenic polyphagia, trauma, diabetes mellitus 

c) When intragastric pressure from gastric distension exceeds 20 cm H2O gastric necrosis starts

d)  clinical features are pain abdomen and effortless vomiting