Gastrointestinal surgery: oesophagectomy complications: 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: oesophagectomy complications

Sample item

On day 5 after a transthoracic oesophagectomy, a patient on enteral feeds drains 1.2 litres a day of milky fluid from the chest tube. The fluid has a high triglyceride content. Which structure was injured?

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

The answer and the reasoning

A. Thoracic duct

Milky pleural fluid rich in triglycerides after oesophagectomy indicates a chyle leak from the thoracic duct. Management is drainage, a low-fat or fasted diet with parenteral nutrition, and ligation if the output stays high. Nerve injury causes hoarseness, not a milky effusion.

Option by option

  • A. Thoracic duct (correct)

    Correct. The thoracic duct carries chyle through the posterior mediastinum.

  • B. Recurrent laryngeal nerve

    The recurrent laryngeal nerve injury gives hoarseness and aspiration.

  • C. Azygos vein

    Azygos injury causes venous bleeding, not milky fluid.

  • D. Left main bronchus

    A bronchial injury causes an air leak, not chyle.

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 A, Thoracic duct. Milky pleural fluid rich in triglycerides after oesophagectomy indicates a chyle leak from the thoracic duct.

Why is "Recurrent laryngeal nerve" not the answer?

The recurrent laryngeal nerve injury gives hoarseness and aspiration.

Why is "Azygos vein" not the answer?

Azygos injury causes venous bleeding, not milky fluid.

Why is "Left main bronchus" not the answer?

A bronchial injury causes an air leak, not chyle.

What concept does this question test?

It tests Gastrointestinal surgery: oesophagectomy complications in General Surgery. Management is drainage, a low-fat or fasted diet with parenteral nutrition, and ligation if the output stays high. Nerve injury causes hoarseness, not a milky effusion.

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: oesophagectomy complications?

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.