Portacaval Anastomosis

Question 1

what is a cause of portal hypertension?

Answer 1

cirrhosis

Question 2

explain the esophageal anastomosis

Answer 2

portal drainage: left gastric V
caval drainage: esophageal V to the azygos V
clinical: black tarry stool, bleeding, esophageal varicies

Question 3

explain the rectal anastomosis

Answer 3

portal drainage: superior rectal Vs to IMV
caval drainage: middle rectal V to internal iliac V
inferior rectal V to internal pudendal V
clinical: painless hemorrhoids due to it occurring above the pectinate line which is where we have visceral innervation

Question 4

explain the umbilicus anastomsis

Answer 4

portal drainage: paraumbilical V
caval drainage: superficial inferior epigastric V to external iliac and femoral Vs
clinical: caput medusa

Question 5

explain the colic anastomosis

Answer 5

portal drainage: colic Vs to SMV
caval drainage: retroperitoneal Vs (renal, suprarenal, paravertebral, gonadal)
clinical: none

Question 6

TIPS procedure

Answer 6

connect the portal V to the hepatic V to the IVC so that the blood can bypass the liver altogether and avoid going into the anastomoses which would continue to raise the BP