Q. Least common complication of Meckel's diverticulum (NEET 2018)
Answer is free
7) c Neoplasm
The most common clinical presentation of Meckel’s diverticulum is gastrointestinal bleeding, which occurs in 25% to 50% of patients who present with complications
intestinal obstruction occur as a result of a volvulus of the small bowel around a diverticulum associated with a fibrotic band attached to the abdominal wall, intussusception, or, rarely, incarceration of the diverticulum in an inguinal hernia (Littre hernia)
Diverticulitis accounts for 10% to 20% of symptomatic presentations.
Neoplasms can also occur in a Meckel’s diverticulum, with NET as the most common malignant neoplasm (77%). Other histologic types include adenocarcinoma (11%), which generally originates from the gastric mucosa, and GIST (10%) and lymphoma (1%).
Q) Which of the following is an Adverse factor hindering spontaneous fistula closure:
a) Tract <1cm
b)Transferrin > 200
c) Location in esophagus
d) First surgery done in the same institution
a) Tract less than 1 cm
Spontaneous fistula closure
Short-turnover protein (prealbumin, retinol-binding protein, transferrin) levels should be measured at least weekly to assess the adequacy of protein delivery. An ongoing catabolic state will adversely affect short-turnover protein levels, even with maximal protein delivery.
Failure of an enterocutaneous fistula to close spontaneously is associated with acronym FRIENDS):
the presence of a foreign body within the tract or adjacent to it, previous radiation exposure of the site, ongoing inflammation (most commonly from Crohn disease) or infection that contributes to a catabolic state, epithelialization of the fistula tract (particularly if the fistula tract is less than 2 cm long), neoplasm, distal intestinal obstruction, and pharmacologic doses of steroids.
Fistulas associated with a concurrent pancreatic fistula also have a low rate of spontaneous closure, as do those occurring in the presence of malnutrition or adjacent infection.
In general, anatomic locations that are favorable for closure are the oropharynx, esophagus, duodenal stump, pancreas, biliary tree, and jejunum.
Question on Duodenal atresia was asked in AIIMS 2017 in April
Q) An infant presents with duodenal atresia. Which of the following is true about this condition?
a) It is the most common GI atresia
b) It presents soon after birth with non bilious vomiting
c) Pre natal detection of duodenal atresia is common
d) Gastro jejunostomy is the procedure of choice to bypass the obstruction
Commonly detected in the pre natal ultrasound
Duodenal atresia is seen in 1:5000 live births .Most common atresia is jejunoileal (1 in 2000). It is associated with lot of other congenital malformations like Down's, prematurity, biliary atresia etc.