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Chapter 3: Abdomen

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A patient presents with a gastric ulcer located in the posterosuperior part of the pyloric canal. The ulcer has perforated the stomach wall and a vessel supplying the region. What artery is most at risk from this ulcer?

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A. Gastroduodenal

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B. Left gastric

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C. Right gastric

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D. Right gastro-omental

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E. Short gastric

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Answer C. The right gastric artery supplies the right part of the lesser curvature of the stomach, including the superior border of the pyloric part of the stomach. It anastomoses with the left gastric artery.

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A 58-year-old male is diagnosed with a tumor on the upper pole of his right kidney. During a posterior approach to the tumor, the surgeon would first encounter:

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A. Pararenal fat

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B. Parietal peritoneum

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C. Perirenal fat

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D. Renal capsule

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E. Renal fascia

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Answer A. Pararenal fat lies external to the renal fascia and is most obvious posteriorly. This layer of fat is in contact with muscles of the posterior abdominal wall. In a posterior surgical approach to the kidney, this layer would be contacted first, followed by renal fascia, perirenal fat, and the renal capsule.

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A 63-year-old male presents to the clinic with chronic abdominal pain that has increased in intensity over the last month. He has a long-standing history of alcohol abuse. Imaging studies confirm a diagnosis of chronic pancreatitis with erosion of the pancreas and damage to adjacent structures. Which artery is most at risk in this patient?

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A. Common hepatic

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B. Gastroduodenal

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C. Left gastro-omental

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D. Short gastric

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E. Splenic

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Answer E. The splenic artery is typically the largest branch of the celiac trunk. It courses along the posterior aspect of the pancreas. With chronic pancreatitis and resulting erosion of gland, this artery may be damaged.

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A 29-year-old male presents to the clinic with diffuse abdominal pain that originated in the groin. During the physical examination, a small reducible mass is observed in the inguinal region. The physician explained it was likely he had an inguinal hernia. During surgical repair, a diagnosis of indirect inguinal hernia is confirmed. How is the surgeon ...

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