Which of the following gastric arteries affected by splenic artery pressure? - USMLE Forums
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Old 09-17-2011
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GIT Which of the following gastric arteries affected by splenic artery pressure?

60-year-old man complains to his doctor that he feels full very quickly, usually after eating only a piece of toast. This has been going on for about 4 months, and he has lost about 40 pounds as a result. His medical history is otherwise negative. He has a 30 pack-year history of smoking. On physical examination, the patient is thin and his spleen is palpated at a length of 14 cm (normal is up to 10 cm). The physician orders an ultrasound, which shows a large gastric tumor impinging on the splenic artery and vein as they pass 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 arteries

Taken from Kaplan Step 1 Qbank

Last edited by ricko335; 09-17-2011 at 04:53 AM.
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E - short gastric arteries arise from splenic artery
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short gastric arteries
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B. Left gastroepiploic
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This should be short gastric arteries b/c they have poor anastomosis if spleenic aa are blocked.
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Old 09-17-2011
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Short gastric artery is the ans bcs it has no anastomosis. . . .though left gastoepiploic artery is brach of splenic artery but it has anastomosis with rt gastroepiploic artery so pressure wont rise
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Old 09-17-2011
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Short gastric artery
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Old 09-18-2011
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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.
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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