For each of the surgical interventions (-ectomy means removal) carried out on the alimentary tract A–E, select the most appropriate possible consequence from the list below

 A. Option 3 Dumping syndrome. When the stomach is removed, ingested food passes very rapidly to the small intestine and can lead to the unpleasant consequences of fluid loss to the intestinal lumen and excessive insulin secretion. The syndrome is called the ‘dumping syndrome’.

B. Option 4 Steatorrhoea. This may be seen following pancreatectomy because lack of lipase allows undigested fat to appear in the faeces.

C. Option 2 Bulky liquid stools. Removal of the colon limits the ability of the alimentary tract to reabsorb water and this results in the passage of watery stools.

D. Option 5 Indigestion after fatty meals. The loss of the gall bladder’s ability to send bile to the duodenum after a fatty meal results in poor digestion and absorption of the meal and hence abdominal discomfort.

E. Option 1 No digestive consequences. The appendix has no known function other than as a lymphoid organ and its immune function can be taken over by other lymphoid tissue in the intestines.