Question
In a patient of liver cirrhosis anastomotic blood flow increase in
| A. |
Left gastric vein & esophageal veins
|
| B. |
Middle colic vein & left colic vein
|
| C. |
Sigmoidal & superior rectal vein
|
| D. |
Superior & inferior phrenic vein
|
Show Answer
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Correct Answer » A
Explanation
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Clinical Reasoning for the Correct Answer:
– In liver cirrhosis, increased portal hypertension develops due to impaired hepatic blood flow.
– Portal hypertension causes portosystemic shunting at sites where portal and systemic venous systems anastomose.
– The left gastric vein (a portal tributary) forms anastomoses with esophageal veins (systemic, draining to azygos system) at the lower esophagus.
– Increased blood flow through these anastomoses leads to esophageal varices—a major complication of cirrhosis.
– Why Option A is Correct:
– Left gastric vein (portal) ↔ esophageal veins (systemic) is the most clinically relevant portosystemic anastomosis in portal hypertension.
– Leads to risk of esophageal varices and life-threatening upper gastrointestinal hemorrhage.
– Why Option B is Incorrect:
– Middle colic vein and left colic vein are both tributaries of the portal system.
– No systemic-portal anastomosis; no major collateral pathway develops here during portal hypertension.
– Why Option C is Incorrect:
– The superior rectal vein (portal) does anastomose with the middle and inferior rectal veins (systemic).
– However, sigmoidal vein is a portal tributary; this pair does not form a significant portosystemic collateral.
– Why Option D is Incorrect:
– Superior and inferior phrenic veins are systemic veins, not directly involved in portal hypertension-related anastomoses.
– No major portosystemic collaterals develop through these veins in cirrhosis.
