best way to approach it is to ask which one has a portal circulation and a systemic circulation ( You DONT need to know the procedure to answer this question.
example: cant be superior epigastric and inferior epigastric because those are both systemic also cant be superior rectal (inferior mesenteric branch) and superior mesenteric because those are both portal system
when you narrow it down, then its a 50/50 guess.
The extrahepatic portocaval shunt for the treatment of portal HT is between the splenic vein and left renal vein.
The intrahepatic portocaval shunt is between the portal vein and hepatic veins.
This can be found in the 100 concepts anatomy ppt.
they're talking about a splenorenal shunt procedure
https://my.clevelandclinic.org/health/treatments/4950-distal-splenorenal-shunt
Ileocolic (systemic)/inferior mesenteric (portal), and splenic (portal)/left renal (systemic) are the only two portosystemic shunt options. Of which splenic and left renal is the BEST option of the two just based on their proximity to the esophageal varices.
Just to add another piece that i think may be worth considering.
Endoscopy is showing gastric varices specifically. In the cases I've encounterd gastric varices due to portal HTN, it relates to the connection between the splenic circulation and the epiplogic/short gastric veins (similar path i think for arterial circulation).
Consequently, gastric varices can be treated by altering the splenic (portal) circulation to a systemic circulation. In this case, the answer was l. renal.
submitted by โusmle11a(102)
ok i think i have a theory in regards for this:
the whole procedure is done to decrease the portal HTN. which means the shunt should be portal to systemic avoiding the liver.
a) hepatic (systemic) to inf phrenic ( systemic ) ; no B) ileocolic (portal ) to inf mesentric (portal) ; no c) splenic (portal) left renal (systemic); yes d) superior epigastric (systemic) to inferior epigastric (systemic) ; No e) superior rectal (portal) to superior mesentric ( portal) ; NO