A 58-year-old male alcoholic is admitted to the hospital after vomiting dark red blood (hematemesis). Endoscopy reveals ruptured esophageal varices, resulting from portal hypertension. Which of the following venous tributaries to the portal system anastomoses with caval veins to cause the varices?
The left gastric vein carries blood from the stomach to the portal vein. At the esophageal-gastric junction the left gastric vein (portal system) anastomoses with esophageal veins (caval system). High blood pressure in the portal system causes high pressure in this anastomosis, causing the ruptured esophageal varices. The splenic vein and its tributaries carry blood away from the spleen and do not form a caval-portal anastomosis. The left gastroomental vein accompanies the left gastroomental artery and joins the splenic vein with no direct anastomosis with caval veins. The left hepatic vein is a caval vein and empties into the inferior vena cava. The right gastric vein drains the lesser curvature of the stomach and is part of the portal system but does not have any caval anastomosis.
Splenic
Left gastroomental
Left gastric
Left hepatic
Abdomen & Pelvis