Abdominal Surgery - Deciding When, What and How to Biopsy

Dr.Jason Mouatt BVSc FANZCVS

Which of the following statements is incorrect or inappropriate:

Correct Answer - (c)

a) Bile can be safely aspirated by placing a needle through medial lobe parenchyma into the gall bladder

b) Kidneys can be biopsied with a Tru-cut biopsy needle aimed from pole to pole

c) Biopsies can be submitted in a single formalin container as long as they don’t clump together

d) Normal intestinal intraluminal pressure is between 2 and 4cm H2O

What is the preferred ( ideal) suture closure option:

Correct Answer -(a)

a) 4-0 monofilament absorbable with appositional suture pattern

b) 2-0 catgut simple interrupted sutures

c) 3-0 monofilament absorbable suture inverting layer

d) 4-0 monofilament absorbable everting pattern

Which of the following is FALSE:

Correct Answer -(a)

a) Liver biopsies are best avoided

b) A peripheral solid liver mass may be removed using a crushing / guillotine suture

c) Multiple small liver samples can often be safely acquired using skin biopsy punches

d) Gelatin sponge can be used to stop bleeding after small punch biopsy defects

Which of the following statements is inappropriate regarding abdominal surgery:

Correct Answer -(b)

a) Every organ should be examined for every exploratory laparotomy

b) If there are no visually detectable abnormalities then biopsies are not likely to add any benefit

c) A long linea alba incision is essential to allow competent and thorough abdominal exploration

d) Falciform ligament removal improves visualisation and reduces risk of infection and necrosis

e) all of the above

If clinical signs suggest a potential gastrointestinal disorder, it is ideal to biopsy what part of the GI tract:

Correct Answer -(e)

a) Stomach

b) duodenum

c) ileum

d) jejunum

e) all of the above