Question:

Which of the following answer choices is not a direct consequence of portal hypertension?
1. Hepatic encephalopathy
2. Right-sided heart failure
3. Gastric bleeding
4. Rectal bleeding
5. Ascites





Answer:

The correct answer for the question "Which of the following answer choices is not a direct consequence of portal hypertension?" is:

2. Right-sided heart failure



Explanation
1. Hepatic encephalopathy is a result of portal hypertension. [The clinical manifestations of liver cirrhosis, including gastrointestinal bleeding, ascites and hepatic encephalopathy, are the result of portal hypertension.]

2. Right-sided heart failure may develop following creation of transjugular portosystemic shunt (TIPS).

3. Gastric variceal bleeding is one of the most common clinical manifestations of portal hypertension.

4. Mesenteric collateral veins between the superior hemorrhoidal and middle/inferior hemorrhoidal veins may develop in patients with portal hypertension. [Although they are less frequent than other collateral veins, rectal bleeding can be associated with this type of portosystemic shunt.]

5. Ascites is one of the clinical manifestations of portal hypertension.



From the manuscript:
Spontaneous Portoazygos Shunt in a Patient with Portal Hypertension
Radiology Case. 2013 Jul; 7(7):32-36


This article belongs to the Interventional section.




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From the manuscript

Spontaneous Portoazygos Shunt in a Patient with Portal Hypertension

Free full text article: Spontaneous Portoazygos Shunt in a Patient with Portal Hypertension

Abstract
We present a case of spontaneous portoazygos shunt in a patient with liver cirrhosis and portal hypertension. The shunt was incidentally detected by abdominal magnetic resonance imaging for routine evaluation of liver cirrhosis. Multiplanar reconstruction images demonstrated the portal vein communicating with the azygos vein that was dilated and tortuous along its course to the mediastinum. Although there has been a case of congenital portoazygos shunt reported in a neonate with multiple congenital anomalies, to the best of our knowledge, this is the first case of spontaneous portoazygos shunt developed in an adult with portal hypertension.






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