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q11 - raji_321
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01-20-2008, 06:16 AM
A large tumor mass impinges on the splenic artery and its branches as the artery passes out from below the greater curvature of the stomach. Branches of which of the following arteries would most likely be affected by the pressure on the splenic artery?
A. Left gastric B. Left gastroepiploic C. Right gastric D. Right gastroepiploic E. Short gastric
01-20-2008, 06:24 AM
The correct answer is E. The splenic artery passes behind the stomach and gives off the short gastric artery and the left gastroepiploic artery immediately after passing the greater curvature. The left gastroepiploic artery has a strong anastomotic connection to another arterial supply while the short gastric does not, so the area supplied by branches of the short gastric arteries is more vulnerable to ischemia in this setting. If the block had occurred proximal to, instead of at the branch point, the short gastric vessels could be supplied by backflow from the left gastroepiploic artery.
The left gastric artery (choice A) is not supplied by the splenic artery. The left gastroepiploic artery (choice B) can be alternatively supplied by its anastomotic connection to the right gastroepiploic artery. The right gastric artery (choice C) is not supplied by the splenic artery. The right gastroepiploic artery (choice D) is normally supplied by the gastroduodenal artery. |
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