Portal and systemic cirulatory anastomosis | PGIMER MCQs for MD MS Preparations

Portal and systemic cirulatory anastomosis occurs at 

a. Around the umbilicus
b. At the lower end of esophagus
c. At the pyloric end of stomach
d. At the anorectal junction
e. Hepatic hexure

Ans.B

A portacaval anastomosis (also known as portal systemic anastomosis or portal caval system) is a specific type of anastomosis that occurs between the veins of portal circulation and those of systemic circulation. The lower end of esophagus is one of the important sites for the portosystemic anastomosis . In portal hypertension, as in the case of cirrhosis of liver, the anastomosis opens and forms venous dilatation called esophageal varices. Their rupture causes severe and dangerous haematemesis (hematemesis). Specific types include:

Region	Name of clinical condition	Portal circulation	Systemic circulation
Esophageal	Esophageal varices	Esophageal branch of left gastric vein	Esophageal branches of Azygos vein
Rectal	Rectal Varices	Superior rectal vein	Middle rectal veins and inferior rectal veins
Paraumbilical	Caput medusae	Paraumbilical veins	Superficial epigastric vein
Retroperitoneal	(no clinical name)	Right colic vein, middle colic vein, left colic vein	Renal vein, suprarenal vein, paravertebral vein, and gonadal vein
Intrahepatic	Patent ductus venosus	Left branch of portal vein	Inferior vena cava