History
He first described the truncal vagotomy for PUD
Who was Lester Dragstedt?
Cells with a hydrogen ion "pump" capable of secreting acid.
What is a parietal cell?
ulcers requiring biopsy and those not requiring biopsy
all gastric ulcers should be biopsied, unnecessary to biopsy most duodenal ulcers
three habits that must be curtailed to allow ulcer healing
what are cessation of smoking, drinking, and avoidance of NSAIDs
Two H pylori associated cancers
What are lymphomas and diffuse gastric adenocarcinomas?
He won the Nobel Prize for discovering H pylori as the bacterium responsible for most PUD
Who was Barry Marshall?
Three neuroendocrine stimuli to acid secretion
what are histamine, acetocholine, and gastrin?
3 methods of diagnosing H pylori
urea breath test, serologic testing, histology, rapid urease test, culture
3 drugs utilized to eradicate H pylori
PPI, clarithromycin, metronidazole, bismuth, tetracycline, amoxicillin
Retained antrum
A condition of hypergastrinemia resulting from the retention of gastric antrum disconnected from acid secreting mucosa, most commonly seen with distal gastrectomy
Alexis St Martin
Who was the backwoods trapper shot in the LUQ, who developed a gastric fistula, allowing William Beaumont the opportunity to study gastric acid secretion in the early 19th century.
The branch of the anterior vagus nerve running along the lesser curvature of the stomach whose branches are severed during highly selective vagotomy
what is the nerve of Laterjet?
non healing 3 cm ulcer at the angularis incisura, benign on initial biopsy. Next steps
What are PPI, H pylori testing, and repeat biopsy in 6-12 weeks?
2 acceptable operations for PUD associated gastric outlet obstruction
what are resection, gastrojejunostomy?
features of gastric remnant cancer
>10 years following gastrectomy, more common after B2, perhaps as a result of bile reflux
He was the first to do a distal gastrectomy and used two methods of reconstruction in the late 19th century
Who was Theodor Billroth
The artery responsible for massive duodenal ulcer bleeding in the duodenal bulb.
What is the gastroduodenal artery?
Octreotide scan
What is a test useful in localizing gastrinomas?
preferred operation for large intractable prepyloric ulcer
what is Vagotomy and antrectomy?
location and management of non healing marginal ulcer after gastric bypass for obesity
what are ulcers found immediately beyond a gastroenterostomy, treated with resection and reconstruction if intractable or obstructing
Operation designed to denervate the gastric fundus and body of the stomach without affecting antral pump function in order to preserve gastric emptying
What is the highly selective vagotomy
80% of all gastrinomas are found here
What is the gastrinoma triangle?
secretin stimulation test
What is the test to diagnosis Z-E as a cause of hypergastrinemia
name 3 acceptable methods of reconstruction after vagotomy and antrectomy
what are gastroduodenostomy (B1), loop gastrojejunostomy (B2), and Roux in Y gastrojejunostomy
3 agents useful to treat alkaline reflux gastritis following gastrojejunostomy of pyloroplasty
what are prokinetics, sucralfate, bile acid binders, PPI's?