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12829 Surgery

A 6-year-old boy experienced life threatening shock, his CT scan showed large amount of ascites, bowel wall thickening and poor or absent enhancement of the strangulated bowel segment, showing gangrenous bowel on surgical exploration. True about anastomosis is

AShould be done by continuous layers as it takes less time
BShould be done with catgut
CShould be done by single layer seromuscular Lambert sutures
DShould be done by Single layer by taking submucosa (Correct Answer)
12834 Surgery

A 35-year-old smoker is involved in a house fire and receives a 45% total surface area burn. One half of the burned surface appears to be third degree. On the third post-burn day, the patient is noted to have bloody drainage from a nasogastric tube and a decrease of 5% in his hematocrit. Appropriate management should include which of the following?

AUrgent upper gastrointestinal contrast study to delineate site of bleeding
BImmediate selective aeriography the left gastric aery to diagnose and treat presumed stress ulceration
CUrgent esophagogastroduodenoscopy to diagnosis the cause of bleeding (Correct Answer)
DUrgent intravenous infusion of vasopressin at 0.2-0.4 IU/min