5. In which races are gallstones particularly common?
Correct answer: They are particularly common in the Mediterranean races, and the highest incidence is found among the Indians of New Mexico.
4. In which sex are gallstones more common?
Correct answer: They are twice as common in women.
3. In which age group are gallstones typically found?
Correct answer: They are rare in children (although they should still be considered in the differential diagnosis of abdominal pain in children if the diagnosis is not to be overlooked, and should always be considered in children with spherocytosis or…
2. What are the principal developmental anomalies of the gallbladder and bile ducts which may present to the surgeon during cholecystectomy?
Correct answer: (1) A long cystic duct travelling alongside the common hepatic duct to open near the duodenal orifice. (2) Congenital absence of the gallbladder.(3) Congenital obliteration of the ducts (biliary atresia, one of the causes of neonatal jaundice).(4) Absence…
1. Developmentally, how do the gallbladder, liver and hepatic ducts form?
Correct answer: A diverticulum grows out from the ventral wall of the foregut (primitive duodenum), which differentiates into the hepatic ducts and the liver. A lateral bud from this diverticulum becomes the gallbladder and cystic duct.
13. Which are the three most common types of hernia to strangulate, in order of frequency from most common to least?
Correct answer: (1) Femoral. (2) Indirect inguinal. (3) Umbilical.
12. What are the clinical features of a strangulated hernia?
Correct answer: If strangulation supervenes, the patient complains of severe pain in the hernia of sudden onset and also of central abdominal colicky pain. The other symptoms of intestinal obstruction – vomiting, distension and absolute constipation – soon appear. Examination…
11. What are the clinical features of an irreducible hernia?
Correct answer: If the hernia will not reduce but is painless and there are no other symptoms, irreducibility is diagnosed. The absence of a cough impulse alone does not indicate strangulation, because in an irreducible femoral hernia, for example, the…
10. What are the clinical features of a reducible hernia?
Correct answer: A reducible hernia simply presents as a lump that may disappear on lying down and that is usually not painful, although it may be accompanied by some discomfort. Examination reveals a reducible lump with a cough impulse.
9. What is a strangulated hernia?
Correct answer: When strangulation occurs, the contents of the hernia are constricted by the neck of the sac to such a degree that their circulation is cut off. Unless relieved, gangrene is inevitable and, if gut is involved, perforation of…
