Surgery Questions on esophagus.
Q1. The usual incision given for surgery of Zenker's diverticulum of esophagus is
a) Left Cervical incision
b) Right Cervical
c) Suprahyoid
d) Midline
1. a
Zenker's diverticulum is a pulsion (false) diverticulum between the cricopharungeal muscle and inferior constrictor muscle in an area Killian's dehiscence.
There may be other areas of weakness as well such as Killian Jamieson area between the oblique and transverse fibres of cricopharyngeal muscle and Laimer's triangle formed between the cricopharyngeal muscle and most superior esophageal wall circular muscles.
(Zenker’s diverticulum) -most common esophageal diverticulum.
Occurs due to
1. Increased upper esophageal sphincter (UES) pressure
2. Failure of UES to relax
3.Incordination between hypophraynx and sphincter to relax
Treatment can be done endoscopically or surgically.
Surgery Esophagomyotomy and resection of the diverticulum- through an oblique left cervical incision
Complications of Surgery for Zenker's divertculum
Salivary fistula 4-24%
Recurrence of Zenker's diverticulum 2.5-20%
Q2. In Transhiatal Vs Trans thoracic esophagectomy most common complication associated with THE (Trans Hiatal esophagectomy) is
a) Pulmonary complications
b) Anastomotic leak
c) Bleeding
d) Injury to recurrent laryngeal nerve
Q3.Which is the most disabling complication after three field esophagectomy?
a) Bronchorrhoea
b) Recurrent laryngeal nerve palsy
c) Tracheal stenosis
d)
Q4. What is the most common complication after esophagectomy
a) Arrhythmia
b) Pulmonary Collapse and Consolidation
c) Recurrent laryngeal nerve injury
d) Massive bleeding
Q 5.Most important investigation for preoperative evaluation of extensive corrosive stricture is
a) Endoscopic ultrasound
b) Barium study
c) CT Thorax
d) Pharyngoscopy
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