A 54-year-old man with a 20-year history of alcohol use disorder presents with massive hematemesis. Vital signs show BP 92/58, HR 118, RR 22, and SpO2 98% on room air. Upper endoscopy reveals dilated tortuous veins in the distal esophagus with recent bleeding. Laboratory studies show elevated AST/ALT ratio of 3:1. Abdominal ultrasound demonstrates cirrhosis with increased portal venous flow. Which venous connection is responsible for development of this lesion?
- A)Superior rectal vein to middle rectal vein
- B)Splenic vein to left renal vein
- C)Paraumbilical veins to superficial epigastric veins
- D)Left gastric vein to esophageal veinsGABARITO
- E)Inferior mesenteric vein to gonadal vein
Explicação
Esophageal varices arise at a portal-systemic anastomosis between the left gastric vein of the portal system and esophageal veins draining to the azygos system. Portal hypertension from cirrhosis drives blood through this collateral pathway, predisposing to li... Ver explicação completa e trilha adaptativa →