Question

A 55-year-old man with a history of drug and alcohol abuse undergoes operative placement of

a portosystemic shunt to relieve portal hypertension. During this procedure, it is most appropriate for the physician to anastomose a major tributary of the portal vein to which of the following vessels?

(A) Left gastric vein
(B) Left renal vein
(C) Splenic vein
(D) Superior mesenteric vein
(E) Umbilical vein

Answer 1

For a 55-year-old man undergoing the placement of a portosystemic shunt to relieve portal hypertension, the physician would anastomose a major tributary of the portal vein to the inferior vena cava, which is not listed among the options provided.

Step-by-step explanation:

In the case of a 55-year-old man with a history of drug and alcohol abuse undergoing the placement of a portosystemic shunt to relieve portal hypertension, the most appropriate vessel for anastomosis with a major tributary of the portal vein would be the inferior vena cava. The goal of this procedure is to divert blood from the portal circulation, which is experiencing high pressure due to portal hypertension, to the systemic circulation, effectively bypassing the liver. None of the options (A) Left gastric vein, (B) Left renal vein, (C) Splenic vein, (D) Superior mesenteric vein, (E) Umbilical vein are typically used for the shunt because they are components of the portal system or not suitable for creating this type of anastomosis. Instead, a portosystemic shunt would commonly involve anastomosis of the portal vein or one of its tributaries to the systemic circulation, typically to the inferior vena cava, to alleviate the symptoms of portal hypertension.