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14375 Surgery

A 30 years old male presented with massive hematemesis. A 2 x 2 cm ulcer was visualized on upper GI endoscopy on the posterior aspect of first pa of duodenum. The bleeding vessel was visualized but bleeding could not be controlled endoscopically. Blood transfusion was done and patient was planned for surgery. Which of the following would be best surgical management?

AAntrectomy with ligation of left gastric aery
BDuodenotomy with ligation of bleeding vessels with postoperative PPI
CDuodenotomy with ligation of bleeding vessels, truncal vagotomy and pyloroplasty
DDuodenotomy with ligation of bleeding vessels, highly selective vagotomy
Surgery
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14377 Surgery

A 40 year old male was brought to the hospital with acute pain in the upper abdomen. Pateint was in shock with feeble pulse and tachycardia. There was tenderness present in the epigastrium. There is no blood in the gastric aspirate and thepatient felt better after aspiration. X-ray abdomen showed no free gas under the diaphragm. Investigations revealed TLC 13500 serum bilirubin 2.0 mg and serum amylase 800 I.U. The most likely diagnosis is –

AAcute cholecystitis
BAcute pancreatitis
CAcute appendicitis
DAcute hepatitis
Surgery
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