Gastrointestinal surgery: intestinal tuberculosis surgery: practice question

A General Surgery question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Surgery · Gastrointestinal surgery: intestinal tuberculosis surgery

Sample item

A young patient from an endemic area has recurrent subacute obstruction with a thickened ileocaecal mass and caseating granulomas on biopsy. After antitubercular therapy, he still has a tight ileal stricture. What is the next step?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Stricturoplasty or limited resection

Intestinal TB is treated medically, and surgery is reserved for complications such as stricture, perforation or fistula. Conservative bowel-preserving surgery is preferred. Hyperplastic ileocaecal TB mimics Crohn disease or carcinoma.

Option by option

  • A. Stop therapy and observe

    A fixed fibrotic stricture will not resolve with drugs alone.

  • B. Total colectomy

    Total colectomy is excessive.

  • C. Extended right hemicolectomy with wide lymphadenectomy

    Oncological resection is not needed for tuberculosis.

  • D. Stricturoplasty or limited resection (correct)

    Correct. Bowel-sparing surgery treats a fixed stricture.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is D, Stricturoplasty or limited resection. Intestinal TB is treated medically, and surgery is reserved for complications such as stricture, perforation or fistula.

Why is "Stop therapy and observe" not the answer?

A fixed fibrotic stricture will not resolve with drugs alone.

Why is "Total colectomy" not the answer?

Total colectomy is excessive.

Why is "Extended right hemicolectomy with wide lymphadenectomy" not the answer?

Oncological resection is not needed for tuberculosis.

What concept does this question test?

It tests Gastrointestinal surgery: intestinal tuberculosis surgery in General Surgery. Conservative bowel-preserving surgery is preferred. Hyperplastic ileocaecal TB mimics Crohn disease or carcinoma.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Gastrointestinal surgery: intestinal tuberculosis surgery?

Learn classic signs and eponyms alongside what they diagnose. Then use the flashcards and the other General Surgery questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.