Gastrointestinal surgery: stagnant loop syndrome: 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: stagnant loop syndrome

Sample item

A man had a side-to-side jejunal anastomosis with a long defunctioned segment. Years later he has weight loss, steatorrhoea, abdominal bloating and macrocytic anaemia with low vitamin B12 that does not improve with oral B12. Which treatment is most appropriate?

AGluten-free dietBPancreatic enzyme replacementCBroad-spectrum antibiotics, with correction of the blind segment if neededDOral iron supplementation

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

The answer and the reasoning

C. Broad-spectrum antibiotics, with correction of the blind segment if needed

A blind or stagnant loop allows bacterial overgrowth. Bacteria deconjugate bile salts, causing fat malabsorption, and consume vitamin B12, causing macrocytic anaemia. Treatment is rotating courses of antibiotics, nutritional correction, and surgical revision of the blind segment when the anatomical cause persists.

Option by option

A. Gluten-free diet
A gluten-free diet treats coeliac disease, which does not follow this surgical anatomy.
B. Pancreatic enzyme replacement
Enzyme replacement treats pancreatic exocrine insufficiency, not bacterial deconjugation.
C. Broad-spectrum antibiotics, with correction of the blind segment if needed (correct)
Correct. Antibiotics reduce the bacterial load, and revision removes the stagnant segment.
D. Oral iron supplementation
Iron deficiency causes microcytic anaemia, but this patient has macrocytic anaemia.

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.

Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is C, Broad-spectrum antibiotics, with correction of the blind segment if needed. A blind or stagnant loop allows bacterial overgrowth.

Why is "Gluten-free diet" not the answer?

A gluten-free diet treats coeliac disease, which does not follow this surgical anatomy.

Why is "Pancreatic enzyme replacement" not the answer?

Enzyme replacement treats pancreatic exocrine insufficiency, not bacterial deconjugation.

Why is "Oral iron supplementation" not the answer?

Iron deficiency causes microcytic anaemia, but this patient has macrocytic anaemia.

What concept does this question test?

It tests Gastrointestinal surgery: stagnant loop syndrome in General Surgery. Bacteria deconjugate bile salts, causing fat malabsorption, and consume vitamin B12, causing macrocytic anaemia. Treatment is rotating courses of antibiotics, nutritional correction, and surgical revision of the blind segment when the anatomical cause persists.

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: stagnant loop syndrome?

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.