Splenic Artery Compression

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Splenic Artery Compression

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new_n_lost
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02/10/07 - 05:08 PM

A large tumor mass impinges on the splenic artery and its branches as the artery passes out from below the gastric curvature of the stomach . Branches of which of the following arteries would most likely get affected by the pressure on the splenic artery?

a- left gastric
b-left gastroepiploic
c-right gastric
d-right gastroepiploic
e-short gastric

Plz Do Explain Ur Choice

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babydoc4usmle
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02/11/07 - 05:47 AM

if this question is about branches than it should be left gastroepiploic, but i don't see how it will be affected because there are anastomoses with right gastroepiploic
gastric arteries don't branch with splenic
i stick with B

alb123
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02/11/07 - 10:52 AM

E.. Ah well splenic aretery gives rise to two major branches in this question. The left gastroepipolic (grastro-omental) and the short gastric arteries. The left gastroepiploic anastomoses with the right gastrepiploic (from the hepatic artery). So it will not experience the greatest deficit from blockage of the splenic artery. The short gastric which supply the spleen will experience the most decreased blood flow. Hence i think E is the BEST answer.

babydoc4usmle
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02/11/07 - 11:06 AM

short gastric arteries a also anastomosed with left gastric and left gastroepiploic arteries
and short gastris arteries supply grater curvature of the stomach, not spleen; splenic artery itself goes to spleen
B and E have anastomoses.....
what is the correct one?

new_n_lost
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02/11/07 - 12:31 PM

thats the point!!!!

the reason i posted this question was this i cudnt find the answer. I thought the same thing that ans shud be E but i thought i get some input from U guys. The question clearly implies pressure on Splenic Artery then its suffice to say that smaller arteries have a greater chance of getting less blood. so bw Lt. Gastro-epiploic artery n Short gastric artery which wud be the answer.

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unique1
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02/11/07 - 03:27 PM

Yes I also think that E should be the answer because the left gastroepiploic art. is a lage artery and makes a rich anstomosis with right gastroepiploic throughout its course while short gastrics are small arteries with a little anastomosis .
Hence pressure on the splenic artery will affect short gastrics more than left gastroepiploic .

Any other input please raised eyebrow

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indidoc1
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02/12/07 - 08:44 AM

Branches of which of the following arteries would most likely get affected by the pressure on the splenic artery?

Now i m beginning to think that the Q doesn't ask us abt anastomosis at all... or it would be.. "parts supplied by which of these would undergo max damage"
even otherwise.. considering the anastomosis.. short gastric arteries are multiple small branches n not a single one... n as if the LGE is ok, they ll have blood flow due to anastomosis... LGE is single n more likely to be compressed by tumors.
I m thoroughly confused but my gut feeling says..its B left gastroepiploic..

PS- The gut ought to know.. After all.. these arteries supply it!! grin

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alb123
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02/12/07 - 09:08 AM

indidoc1, so you think the question is asking which artery blockage would yeild most damage? If so, i still say E, how else would the spleen get its required blood supply, whereas the gastroepiploic (left) would still get adequate supply from the right GE. I know that the short gastric anastomose with the left gastroepiploic, but the lengthier transiet time and increased need for O2 by the deprived part of the stomach would sufficiently injur the spleen by decreasing its nuritousment.
let me know you thoughts..

indidoc1
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02/15/07 - 06:55 AM

alb123 wrote:
indidoc1, so you think the question is asking which artery blockage would yeild most damage? If so, i still say E, how else would the spleen get its required blood supply, whereas the gastroepiploic (left) would still get adequate supply from the right GE. I know that the short gastric anastomose with the left gastroepiploic, but the lengthier transiet time and increased need for O2 by the deprived part of the stomach would sufficiently injur the spleen by decreasing its nuritousment.
let me know you thoughts..

No, as i hd written earlier i DON'T THINK the question is asking which artery blockage would yield most damage. I think its asking abt which one hs the least blood if the occlusion occurs?
I hv read all the above arguments... Kinda still inclined towards LGE bcoz..

1- I m beginning to conclude that maybe anastomosis will not play a role in this decision... We obviously won't be occluding splenic artery fr treatment of its aneurysms if its occlusion causes infarctiom of some area.. So the argument that which artery hs better anastomosis may not count.. both will function..

2- So, it comes down to which branch can be compressed by a tumor which compresses the splenic artery.. As short gastric r multiple branches.. chances of all of them being occluded don't seem too bright.. So.. LGE's the one fr me...

Lets have the last words in frm everyone n end this discussion..its too long already smiling face

Edited by indidoc1 on 02/15/07 - 07:27 AM

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yarab99
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03/16/08 - 04:38 AM

#10

so nnl what was the answer????

new_n_lost
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03/16/08 - 03:06 PM

#11

Well i am more inclined towards E. This is probably a KQbank question to which i have no answer.

Your inputs will be appreciated.

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macintosh
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04/02/08 - 06:47 AM

#12

Isn't the short gastric arteries itself branches of the splenic artery. As i do not see splenic artery among the answer choices I think the only other likely choice could be the branches from the left gastroepiploic artery.

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