Gross Anatomy: Middle Ear Cavity

Dumping syndrome after peptic ulcer surgery

A 44-year-old man with a history of peptic ulcer surgery presents with palpitations, tachycardia, lightheadedness, and diaphoresis after eating a meal. The symptoms typically begin 30 min after eating.Which of the following is the most likely diagnosis?

• a.Malabsorption
• b.Peptic ulcer recurrence
• c.Gastric carcinoma
• d.Gastritis
• e.Dumping syndrome
• f.Esophagitis

The answer is (e).

Some patients with a history of ulcer surgery experience the dumping syndrome 30 min after eating. They present with palpitations, tachycardia, lightheadedness, and diaphoresis after eating a meal due to the rapid emptying of hyperosmolar gastric contents into the small intestine.
Dumping syndrome is also called rapid gastric emptying which occurs when the undigested food bypass the  stomach and transported or "dumped" into the small intestine too rapidly.

Myringotomy tube insertion

Example of myringotomy and tube placement. Tubes are inserted for chronic are signifcant recurrent ear infections. They typically stay several months to a couple of years. They are intended to ventilate the middle ear space in order to treat as well as prevent future middle ear infections.

Atypical "Rodent Ulcer" Basal Cell Carcinoma

These lesions are moist ulcers which may not have the characteristic rolled, translucent border of a nodular Rodent Ulcer or Basal Cell Carcinoma BCC. Often, they are much larger than the pre-auricular lesion seen here, and represent neglected lesions.

The typical basal cell carcinoma appears as a small, pearly, dome-shaped nodule with small visible blood vessels (telangiectasias).