This blog deals exclusively with questions on stomach

Q 1 Gastrointesinal stromal tumors false statements
a) it is the most common primary non epithelial tumor of stomach and small bowel
b) It occurs due to activation of KIT mutations
c) Imatinab is a useful drug in GIST
d) It is same as a smooth muscle tumor

Q2) Treatment of choice for gastric volvulus

a)Ant Gastropexy

b)Posterior Gastropexy

c)Gastrectomy

d)


A1) d
These tumors are unique because they occur as a consequence of activating KIT mutations, express KIT proteins . Imatinab is a new therapy which has changed prognosis as it is directed against KIT protein
KIT protein overexpression is detected by immunohistochemical staining for CD117 and this is its defining feature which differentiates it from smooth muscle tumors
Smooth muscle tumor is Vimentin positive, Smooth muscle Actin (SMA) positive and Desmin positive, GIST can be Vimentin positive but Desmin negative
GI Surgery Annual 9th edition page 102

A2) a

Organoaxial rotation is more common than mesenterioaxial and anterior is more common than posterior.

Management is laparotomy, hiatal hernia repair and fixing the antrum to ant abd wall, fundoplication may or may not be done, gastrectomy done if necrosis is present.

Schakelford 18