A 56-year-old man comes to the physician complaining of early satiety, nausea, and vague epigastric pain for the past 4 months. He has a 36-pack-year smoking history and admits to drinking alcohol daily for the past 15 years. On physical examination, the patient appears thin and cachectic. Palpation of his abdomen reveals splenomegaly. Abdominal CT scan shows a large irregular mass extending posteriorly from the greater curvature of the stomach, impinging on the splenic artery and vein as they pass below. Tissues supplied by which of the following arteries would most likely be affected by compression of the splenic artery?

Question

A 56-year-old man comes to the physician complaining of early satiety, nausea, and vague epigastric pain for the past 4 months.  He has a 36-pack-year smoking history and admits to drinking alcohol daily for the past 15 years.  On physical examination, the patient appears thin and cachectic.  Palpation of his abdomen reveals splenomegaly.  Abdominal CT scan shows a large irregular mass extending posteriorly from the greater curvature of the stomach, impinging on the splenic artery and vein as they pass below.  Tissues supplied by which of the following arteries would most likely be affected by compression of the splenic artery?

Quizplus · Accepted Answer

11ec160b_3580_3b0b_9249_4f29870e5796_MD0001_00 The splenic artery originates from the celiac artery and courses superior to the pancreas. Along its route, it gives off several branches to the stomach and pancreas before reaching the spleen. The short gastric arteries and the left gastroepiploic artery arise from the splenic artery immediately after it passes the greater curvature of the stomach. The short gastric arteries have very poor anastomoses, and the tissue supplied by them is vulnerable to ischemic injury following splenic artery blockage. In contrast, tissues supplied by the left gastroepiploic artery can be alternatively supplemented by its strong anastomotic connection with the right gastroepiploic artery (Choice B). (Choice A) The gastroduodenal artery supplies blood to the pylorus and the proximal part of the duodenum. It arises from the common hepatic artery. (Choice C) The right gastric artery supplies blood to the distal lesser curvature of the stomach. It arises from the proper hepatic artery. (Choice D) The right gastroepiploic artery arises from the gastroduodenal artery and perfuses the distal greater curvature of the stomach. It forms an anastomosis with the left gastroepiploic artery. Educational objective: The splenic artery originates from the celiac artery and gives off several branches to the stomach and pancreas (pancreatic, short gastric, and left gastroepiploic arteries) before finally reaching the spleen. Due to poor anastomoses, the gastric tissue supplied by the short gastric arteries is vulnerable to ischemic injury following splenic artery blockage.

A 56-Year-Old Man Comes to the Physician Complaining of Early