Home >> Surgery >> ForumTopic: Surgery mcq of the day
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| residency2009 Total Posts: 25 | Posted: Mon Nov 03, 2008 10:09 pm Hi, A 65 year old woman with known duodenal ulcer being treated by H2 blocker therapy is admitted with upper gastrointestinal bleeding. After blood replacement is begun the next step is her management should be A) institute anti H. pylori treatment B) repeated gastric lavage C) endoscopy and coagulation of bleeding vessel D) pyloroduodenotomy and oversewing of the bleeding vessel The answer given is D, I feel it should be C, begin with endoscopy and if it doesn't improve, surgical intervention is required. Can anybody shed some light on this Thanks |
| juhidr Total Posts: 149 | Posted: Tue Nov 04, 2008 07:43 am i feel that the answer should be "B" - - Repeat gastric lavage will tell whether bleeding is continuing or it has stopped. - If continuing go for endoscopy and if it does not stop then go for pyloroduodenotomy & oversewing - If stopped, then go for anti - H pylori treatment  |
| superbdoc Total Posts: 273 | Posted: Tue Nov 04, 2008 02:42 pm such a confusion in the run-up to AIIMS....pls where is kolsurgeon..??  |
| cheti Total Posts: 3 | Posted: Wed Nov 05, 2008 12:20 am i also think answer is c first coagulation of bleeding vessel should be done |
| qussay Total Posts: 1 | Posted: Sun Nov 08, 2009 06:45 pm i think the answer should be c you nust do endoscopy after ressusitation and see wether bleeding is continue or stopped . If stopped you can be conservative if not try endoscopic therapy together with proton pump inhibitors and anti-H Pylori.If still bleeding then dopyloroduodenotomy |
| chimpu09 Total Posts: 16 | Posted: Mon Nov 09, 2009 01:14 am The answer should be B. If there is no bleeding on gastric lavage, then there is no point in going for endoscopy. |