stomach

Afferent loop syndrome

Q) Not true about afferent loop syndrome

a) It can occur after either partial or total gastrectomy with Billroth ii reconstruction or roux en y gastrojejunostomy

b) Acute obstruction is more common than chronic

c) Weight loss and anemia are common.

d) Bacterial overgrowth in afferent limb causes malabsorption of fat and other nutrients, such as vitamin B12 or iron.

Q) What is not true about the role of PET Scan in staging of Ca Stomach?

a) 50% of Carcinoma stomach are PET avid

b) Response to Neoadjuvant therapy is usually seen on PET in 2 weeks

c) PET response correlates with survival

d) Sensitivity of PET is same for all kinds of histopath tumors

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

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