MCQ Hepatobiliary Portal Hypertension II

  1. MC cause of gastric varices?
    : CirrhosisQ
  2. MC cause of isolated gastric varices?
    Splenic vein thrombosisQ
  3. Sarin classification of Gastric Varices?
    • :1. Gastroesophageal varices
    • 2. Isolated gastric varices.
    • ₋₋Type 1: Varices located in the fundus of the stomachQ
    • ₋₋Type 2: Isolated ectopic varices located anywhere in the stomachQ
  4. Cause of isolated gastric varices?
    Secondary to splenic vein thrombosisQ
  5. Treatment of gastric varices?
    • Gastric varices in splenic vein thrombosis: SplenectomyQ.
    • Gastric varices in portal hypertension - managed like esophageal varicesQ.
  6. Vessels involved in gastric varices?
    • In portal HTN - transmitted by the left gastric veinQ to esophageal varices and by the short and posterior gastric veinsQ to the fundic plexus and cardia veins.
    • Splenic blood flows retrograde through the short and posterior gastric veins into the varices, then hepatopetally through the coronary veinQ into the portal vein.
  7. Technique of Placement of TIPPS?
    • Right internal jugular vein -shortest and most direct path to catheterize the hepatic veinsQ.
    • Right hepatic vein is MC used - largest hepatic vein and has the most favourable orientationQ.
    • Portal vein is cannulated by Rosch needle.
    • Portal vein is localized by carbon dioxide wedge hepatic venographyQ.
    • Portal venogram before dilating parenchymal tract is crucial, provides confirmation that portal vein has been accessed
  8. Features of Stent in TIPPS?
    • • The VIATORR is a stent-graftQ specifically designed for TIPSS
    • .• 2 cm long bare stent segment - consists of three PTFE layersQ, one of which is an impermeable film to prevent bile leak into the shunt.
  9. Indications of TIPSS?
    • 1. Prevention of rebleeding from varices (MC)Q
    • 2. Acute variceal BleedingQ
    • 3. Refractory ascitesQ
    • 4. Hepatorenal syndromeQ
    • 5. Refractory hepatic hydrothoraxQ
    • 6. Budd-Chiari syndromeQ
    • 7. Hepatic veno-occlusive diseaseQ
    • 8. Portal hypertensive gastropathyQ
  10. Cause of stenosis in TIPPS?
    Neointimal hyperplasia and is more common than thrombosisQ
  11. Types of non-selective shunt?
    • 1. Eck fistulaQ
    • 2. Side-to-side PCS (SSPCS)Q
    • 3. Interposition graft (portacaval, mesocaval, mesorenal)Q
    • 4. Proximal splenorenal shuntQ
  12. Types of selective shunt?
    • 1. Distal splenorenal shunt (Warren shuntQ)
    • 2. Inokuchi shuntQ
  13. What is partial shunt?
    Diameter of shunt <10 mmQ
Card Set
MCQ Hepatobiliary Portal Hypertension II
Portal hypertension