portosystemic anastomoses

Question 1

esophagus anastomosis: clinical sign?

Answer 1

esophageal varices

Question 2

esophagus anastomosis: portal and systemic vein?

Answer 2

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

Question 3

esophagus anastomosis: where does the blood drain?

Answer 3

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

leads to esophageal varisces

Question 4

umbilicus anastomosis: clinical sign?

Answer 4

caput medusae

Question 5

umbilicus anastomosis: portal and systemic vein?

Answer 5

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

Question 6

where are the small epigastric veins located?

Answer 6

anterior abdominal wall

Question 7

anastomosis of paraumbilical and small epigastric veins: clinical sign?

Answer 7

abdominal varices

Question 8

abdominal varisces is suggestive of which anastomosis?

Answer 8

paraumbilical (portal) and small epigastric veins (systemic)

Question 9

esophageal varisces suggestive of which anastomosis?

Answer 9

umbilicus

Question 10

rectum anastomosis: clinical sign?

Answer 10

anorectal varisces

Question 11

umbilicus anastomosis: which direction does the blood drain?

(in case of portal hypertension)

Answer 11

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

Question 12

rectum anastomosis: portal and systemic veins?

Answer 12

portal: superior rectal
systemic: middle and inferior rectal

Question 13

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

(when portal hypertension)

Answer 13

caput medusae

Question 14

rectum anastomosis: blood flows where?

Answer 14

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

Question 15

which direction does the blood flow in portosystemic anastomoses?

(in case of portal hypertension)

Answer 15

from portal to systemic

Question 16

what are the clinical signs of portal hypertension?

Answer 16

esophageal varisces
anorectal varisces
caput medusae

‘gut, butt and caput’

Question 17

TIPS is short for?

Answer 17

transjugular intrahepatic portosystemic shunt

Question 18

what is a TIPS treatment?

Answer 18

shunt between portal vein and hepatic vein (systemic)

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

Question 19

common cause of portal hypertension?

Answer 19

liver cirrhosis

Question 20

effect of TIPS treatment?

Answer 20

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

Question 21

which organ gets bypassed with TIPS treatment?

Answer 21

liver

Question 22

TIPS: shunt between which veins?

Answer 22

portal and hepatic (systemic)

Question 23

what can condition can TIPS precipitate/cause?

Answer 23

hepatic encephalopathy

Question 24

why can TIPS cause hepatic encephalopathy?

Answer 24

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

Question 25

what is hepatic encephalopathy?

Answer 25

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

(can also be other toxins)