Hepatobiliary and pancreatic surgery: bleeding gastric varices: 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.

Try it

General Surgery · Hepatobiliary and pancreatic surgery: bleeding gastric varices

Sample item

A cirrhotic patient with portal hypertension has acute bleeding from isolated fundal gastric varices extending from the cardia. What is the preferred endoscopic treatment?

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

The answer and the reasoning

C. Cyanoacrylate glue injection

Bleeding gastric varices are best treated by endoscopic injection of cyanoacrylate glue, which obliterates the vessels. Band ligation is effective for oesophageal varices but is less suited to large gastric varices, and tamponade is a temporary bridge.

Option by option

  • A. Endoscopic band ligation

    Ligation of large gastric varices is technically difficult and prone to post-banding ulcer bleeding.

  • B. Prolonged balloon tamponade

    Tamponade only buys time and cannot be left in place for long.

  • C. Cyanoacrylate glue injection (correct)

    Correct. Tissue adhesive is the standard endoscopic treatment for fundal gastric varices.

  • D. Ethanolamine sclerotherapy

    Sclerosant injection carries a higher rebleeding rate in gastric varices.

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.

More General Surgery questions

Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is C, Cyanoacrylate glue injection. Bleeding gastric varices are best treated by endoscopic injection of cyanoacrylate glue, which obliterates the vessels.

Why is "Endoscopic band ligation" not the answer?

Ligation of large gastric varices is technically difficult and prone to post-banding ulcer bleeding.

Why is "Prolonged balloon tamponade" not the answer?

Tamponade only buys time and cannot be left in place for long.

Why is "Ethanolamine sclerotherapy" not the answer?

Sclerosant injection carries a higher rebleeding rate in gastric varices.

What concept does this question test?

It tests Hepatobiliary and pancreatic surgery: bleeding gastric varices in General Surgery. Band ligation is effective for oesophageal varices but is less suited to large gastric varices, and tamponade is a temporary bridge.

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 Hepatobiliary and pancreatic surgery: bleeding gastric varices?

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.