FINAL EXAM NATIONAL BOARD OF EXAMINATIONS
DECEMBER 2016
POSSESSION USE OF CELL PHONES OR ANY SUCH ELECTRONIC GADGETS IS NOT PERMITTED INSIDE THE
EXAMINATION HALL.
SURGICAL GASTROENTEREOLOGY
PAPER II
SURG.GASTRO/D/16/46/II
Time 3 hours
Max. Marks 100
Important instructions:
• Attempt all questions in order.
• Each question carries 10 marks.
• Read the question carefully and answer to the point neatly and legibly.
• Do not leave any blank pages between two answers.
• Indicate the question number correctly for the answer in the margin space.
• Answer all the parts of a single question together.
• Start the answer to a question on a fresh page or leave adequate space between two answers.
• Draw table/diagrams/flowcharts wherever appropriate.
Write short notes on:
1. Diagnosis and management of a patient with asymptomatic portal
cavernoma cholangiopathy in a patient with extra hepatic portal
venous obstruction.
5+5
2. List the predisposing factors for development of a hepatocellular
carcinoma.
Diagnosis and staging of hepatocellular carcinoma.
3+7
3. Step up approach to the management of a patient with severe
necrotizing pancreatitis.
List the indications for surgical intervention in the first four
weeks after onset of the disease.
8+2
4. How would you diagnose a 'small-for-size' syndrome after liver
resection or transplantation?
How will you manage such a patient?
4+6
5. Advantages and disadvantages of pancreatico-duodenectomy
performed laparoscopically.
5+5
6. Management of a patient with intra-operatively recognized
transection of the common bile duct during laparoscopic
cholecystectomy being done by a general surgeon at a district
hospital.
10
7. Clinical presentation, diagnosis and management of a patient
suspected to have an insulinoma.

8. In a patient with surgical obstructive jaundice:
List the various methods of percutaneous biliary drainage.
Complications of any one method.
List the absolute and relative indications for percutaneous biliary
drainage.

9. Compare the advantages and disadvantages of deceased donor
and living donor liver transplantation.
5+5
10. Diagnosis and management of a patient with suspected
xanthogranulomatous cholecystitis.
4+6