portosystemic anastomoses Flashcards
esophagus anastomosis: clinical sign?
esophageal varices
esophagus anastomosis: portal and systemic vein?
portal: left gastric
systemic: esophageal (drains into azygos)
esophagus anastomosis: where does the blood drain?
from left gastric (portal) towards esophageal vein (systemic)
leads to esophageal varisces
umbilicus anastomosis: clinical sign?
caput medusae
umbilicus anastomosis: portal and systemic vein?
portal: paraumbilical
systemic: small epigastric veins (branches of inferior and superficial epigastric veins)
where are the small epigastric veins located?
anterior abdominal wall
anastomosis of paraumbilical and small epigastric veins: clinical sign?
abdominal varices
abdominal varisces is suggestive of which anastomosis?
paraumbilical (portal) and small epigastric veins (systemic)
esophageal varisces suggestive of which anastomosis?
umbilicus
rectum anastomosis: clinical sign?
anorectal varisces
umbilicus anastomosis: which direction does the blood drain?
(in case of portal hypertension)
from paraumbilical vein (portal) to small epigastric veins (systemic)
rectum anastomosis: portal and systemic veins?
portal: superior rectal
systemic: middle and inferior rectal
blood flows from from paraumbilical vein (portal) to small epigastric veins (systemic): clinical sign?
(when portal hypertension)
caput medusae
rectum anastomosis: blood flows where?
from superior rectal (portal) to middle and inferior rectal (systemic)
which direction does the blood flow in portosystemic anastomoses?
(in case of portal hypertension)
from portal to systemic
what are the clinical signs of portal hypertension?
esophageal varisces
anorectal varisces
caput medusae
‘gut, butt and caput’
TIPS is short for?
transjugular intrahepatic portosystemic shunt
what is a TIPS treatment?
shunt between portal vein and hepatic vein (systemic)
(relieves the portal hypertesion by shunting blood towards the systemic circulation, bypassing the liver)
common cause of portal hypertension?
liver cirrhosis
effect of TIPS treatment?
relieves the portal hypertension by shunting blood towards the systemic circulation, bypassing the liver
which organ gets bypassed with TIPS treatment?
liver
TIPS: shunt between which veins?
portal and hepatic (systemic)
what can condition can TIPS precipitate/cause?
hepatic encephalopathy
why can TIPS cause hepatic encephalopathy?
reduced clearence of ammonia (because blood doesn’t pass through liver)
what is hepatic encephalopathy?
accumulation of ammonia in nervous system
e.g. due to liver shunting
(can also be other toxins)
