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Chapter 25. Stomach & Duodenum

The blood supply to the stomach

A. Typically includes direct branches from the celiac axis and superior mesenteric artery

B. Includes predominant supply of the greater curve of the stomach by the left gastric artery

C. Includes the right gastroepiploic artery, which is usually a branch of the splenic artery

D. May include a posterior gastric artery that is typically a branch of the splenic artery

E. Is anatomically separate from the blood supply to the spleen

The correct answer is D. May include a posterior gastric artery that is typically a branch of the splenic artery

Which of the following is true about gastric volvulus?

A. All patients presenting with gastric volvulus must emergently go to the operating room.

B. Associated mortality rate is as high as 56%.

C. Acute volvulus is more common than chronic volvulus.

D. Patients typically present with no symptoms.

E. Mesenteroaxial volvulus is more common than organoaxial volvulus.

The correct answer is B. Associated mortality rate is as high as 56%

The surgical management of gastric cancer

A. Is better with Billroth I reconstruction

B. Requires resection of uninvolved margins of stomach, duodenum, and regional lymph nodes

C. Requires bypass when there is an obstructing tumor at the gastroesophageal junction

D. Is limited to palliative resection for cancers that are stage III and above

E. Is often preceded by neoadjuvant chemotherapy

The correct answer is B. Requires resection of uninvolved margins of stomach, duodenum, and regional lymph nodes

Vagotomy

A. Can impair the appropriate relaxation of the pylorus

B. Has several variations, but each denervates the pylorus

C. Has become more widely applied as ulcer therapy since the introduction of acid-suppressing medications (H2 blockers and proton pump inhibitors)

D. Impairs gallbladder emptying

E. Can include division of both the left (posterior) and right (anterior) vagus nerve trunks

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