Dumping Syndrome

Q) What is the mechanism of action of Octreotide in dumping syndrome ?

a) Acceleration of gastric emptying

b) Shortening of small bowel transit time

c) Inhibition of endocrine secretions

d) All the above

Answer: C

  • Octreotide alleviates both early and late dumping symptoms through inhibition of hormone mediators.
  • It also delays gastric emptying time and inhibits splanchnic vasodilation.

Shack, 8th, 722.

  • These peptides not only inhibit gastric emptying but also affect small bowel motility so that intestinal transit of the ingested meal is prolonged.

Sabistan, 21st, 1217.

Snippets

  • Late dumping occurs 1 to 3 hours after a meal and is less common.
  • The basic defect of late dumping is also rapid gastric emptying; however, it is related specifically to carbohydrates being delivered rapidly into the proximal intestine.

Surgery for Gastric volvulus

Q)   Which is not an operative approach in  in gastric volvulus? ( Click for  more Questions on Stomach) 

a) Tanner

b) Opolzsr

c) Grey Ghimmenton

d) Gavrilu

Ans  d ) Gavrilu

Gavrilu is  trans-abdominal myotomy and antireflux procedure using a flap of greater curvature of stomach to be sutured over esophageal mucosa through a left subcostal incision

Division of gastro colic ligament and gastropexy is tanner

Splitting the meso colon and doing a gastropexy is grey ghimelton

Fundo antral gastrogastrostomy - opolzsr
Sabiston Textbook of Surgery: The Biological Basis of Modern Surgical Practice

Extra 

There are two main types of gastric volvulus:

  1. Organo-axial volvulus: In this type, the stomach twists along its long axis, causing the stomach to rotate excessively. This type is often associated with conditions that result in an elongated stomach, such as diaphragmatic hernias or paraesophageal hernias.
  2. Mesentero-axial volvulus: This type involves the stomach twisting around its mesentery, a fold of tissue that connects the stomach to other organs. It is less common than organo-axial volvulus and can be associated with conditions that cause the stomach to be in an abnormally mobile position.

Peptic Ulcer Location

Q) False statement about location of peptic ulcer?

a) Type 1 is on greater curvature

b) Type 2 is gastric body and duodenal

c) Pauchet procedure is for type IV

d) Type Iv is high on lesser curvature

Ans 16) a

TYPE             LOCATION                             ACID LEVEL
I                   Lesser curve at incisura         Low to normal
II               Gastric body with duodenal ulcer Increased
III                      Prepyloric                           Increased
IV                   High on lesser curve               Normal
V                        Anywhere                            Normal,

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