portosystemic anastomoses Flashcards

1
Q

esophagus anastomosis: clinical sign?

A

esophageal varices

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2
Q

esophagus anastomosis: portal and systemic vein?

A

portal: left gastric
systemic: esophageal (drains into azygos)

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3
Q

esophagus anastomosis: where does the blood drain?

A

from left gastric (portal) towards esophageal vein (systemic)

leads to esophageal varisces

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4
Q

umbilicus anastomosis: clinical sign?

A

caput medusae

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5
Q

umbilicus anastomosis: portal and systemic vein?

A

portal: paraumbilical
systemic: small epigastric veins (branches of inferior and superficial epigastric veins)

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6
Q

where are the small epigastric veins located?

A

anterior abdominal wall

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7
Q

anastomosis of paraumbilical and small epigastric veins: clinical sign?

A

abdominal varices

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8
Q

abdominal varisces is suggestive of which anastomosis?

A

paraumbilical (portal) and small epigastric veins (systemic)

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9
Q

esophageal varisces suggestive of which anastomosis?

A

umbilicus

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10
Q

rectum anastomosis: clinical sign?

A

anorectal varisces

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11
Q

umbilicus anastomosis: which direction does the blood drain?

(in case of portal hypertension)

A

from paraumbilical vein (portal) to small epigastric veins (systemic)

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12
Q

rectum anastomosis: portal and systemic veins?

A

portal: superior rectal
systemic: middle and inferior rectal

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13
Q

blood flows from from paraumbilical vein (portal) to small epigastric veins (systemic): clinical sign?

(when portal hypertension)

A

caput medusae

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14
Q

rectum anastomosis: blood flows where?

A

from superior rectal (portal) to middle and inferior rectal (systemic)

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15
Q

which direction does the blood flow in portosystemic anastomoses?

(in case of portal hypertension)

A

from portal to systemic

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16
Q

what are the clinical signs of portal hypertension?

A

esophageal varisces
anorectal varisces
caput medusae

‘gut, butt and caput’

17
Q

TIPS is short for?

A

transjugular intrahepatic portosystemic shunt

18
Q

what is a TIPS treatment?

A

shunt between portal vein and hepatic vein (systemic)

(relieves the portal hypertesion by shunting blood towards the systemic circulation, bypassing the liver)

19
Q

common cause of portal hypertension?

A

liver cirrhosis

20
Q

effect of TIPS treatment?

A

relieves the portal hypertension by shunting blood towards the systemic circulation, bypassing the liver

21
Q

which organ gets bypassed with TIPS treatment?

A

liver

22
Q

TIPS: shunt between which veins?

A

portal and hepatic (systemic)

23
Q

what can condition can TIPS precipitate/cause?

A

hepatic encephalopathy

24
Q

why can TIPS cause hepatic encephalopathy?

A

reduced clearence of ammonia (because blood doesn’t pass through liver)

25
Q

what is hepatic encephalopathy?

A

accumulation of ammonia in nervous system
e.g. due to liver shunting

(can also be other toxins)

26
Q
A