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alcoholic - zkadhem
#1
Question 3 of 3
A 37-year-old man with a history of alcohol abuse was seen in the emergency room complaining of stomach cramps in the region of the umbilicus. He reported several recent incidents of vomiting that contained no noticeable blood, although he had in the past vomited bright red blood. He insisted that he had been on the wagon for the past several months. Physical examination revealed a mass about the umbilicus with indications of periumbilical peritoneal inflammation. His white blood cell count was high and he had a temperature of 39.4°C (103°F). He was admitted to the surgical service for emergency reduction of an umbilical hernia with suspected strangulation.

On manual exploration of the abdominal cavity, the liver was felt to be hard and nodular. This, in addition to the history of hematemesis, indicated that control of the portal hypertension was necessary. In a patient with cirrhosis of the liver, venous hypertension would be expected in which of the following veins?
A.Hepatic vein
B.Renal vein
C.Short gastric veins
D.Suprarenal vein
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#2
c?
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#3
C.Short gastric veins ?
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#4

The answer is: C

The short gastric veins are branches of the splenic vein and, therefore, would experience the portal pressure. The short gastric veins also anastomose with the esophageal veins and produce esophageal varices. The hepatic vein, between the liver and inferior vena cava, drains the liver and is not part of the portal system. There are no communications between the portal system and the renal or suprarenal veins
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