Q) Hyperbaric oxygen therapy in radiation proctitis all are true except A. Indicated in acute radiation proctitis but not in subacute or chronic radiation proctitis B. Oxygen increases the growth of residual tumor and hence tumor should be completely resected C. Complications include Parkinsonism, barotrauma D. Usually 30-40 sessions are required for treatment
Hyperbaric oxygen overcomes chronic tissue hypoxia in radiation damaged tissues and with repeated sessions induces growth of regenerative tissue, capillaries, and epithelium. Successful therapy may take multiple sessions. 18 to 60 treatments
Ref Shackelford page 2211
HBO treatments for hypoxic wounds are usually delivered at 1.9 to 2.5 atm
for sessions of 90 to 120 minutes each. Treatments are given once daily, five to six times per week and should be given as an adjunct to surgical or medical therapies. Clinical evidence of wound improvement should be noted after 15 to 20 treatments.
Q) Antral GIST 1cm incidentally found on UGIE. True regarding its management a) Surgical resection b) Endoscopic resection c) Resection required if EUS suggests irregular border with cystic spaces d) Endoscopic surveillance, if size >2cm then resect
GIST more than 2 cm should undergo resection. Management of GIST less than 2 cm is dependent on weather high risk features are present on EUS.
The high risk features are
1. Irrgeular margins
2. Heterogenous architecture
Management of low risk GIST less than 2 cm is surveillance every 6 months