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NBME 21 Answers

nbme21/Block 3/Question#17

A 66-year-old woman with pancreatic cancer comes to ...

Short gastric

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 +3  upvote downvote
submitted by saifshaikh(4),

There is splenic vein thrombosis. The short gastric veins normally drain into the splenic vein. Due to the thrombosis, there may be fluid backup and increased pressure, resulting in varices.





 +1  upvote downvote
submitted by dr.xx(34),

Gastric varices are fed by the short gastric veins.

https://www.sciencedirect.com/science/article/pii/B9781437707748100764

cienfuegos  Add'l UW fun fact is differentiating from gastric varices 2/2 PHTN: Gastric varices: can also be seen w/ splenic vein throbmobis 2/2 chronic panceatitis, pancreatic cancer and abdominal tumors - gause gastric varices only in the fundus (remainder of stomach and esophagus usually not affected vs. PHTN: increased pressure in left gastric vens thus both gastric and esophageal varices) +  




 +0  upvote downvote
submitted by dr.xx(34),

More fully: Afferents to gastric varices. The afferents to GV come from left gastric vein, short gastric veins and posterior gastric vein the left gastric vein mainly contributes to formation of cardiac varices whereas the short gastric vein and posterior gastric vein contribute to formation of fundal varices. Isolated gastric varices are more likely to be related to gastroepiploeic veins.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3940321/





 +0  upvote downvote
submitted by sahusema(12),

The question says GASTRIC varices, not ESOPHAGEAL varices. My stupid brain. Plus I'm assuming left gastroepiploic would be a correct answer if it was listed.