Abdomen: splenic vein and pancreas: practice question

A Anatomy question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Anatomy · Abdomen: splenic vein and pancreas

Sample item

A 45-year-old man with chronic pancreatitis has haematemesis. Endoscopy shows gastric fundal varices without oesophageal varices. The spleen is enlarged, and liver function and portal vein flow are normal. Thrombosis of which vessel is the likely cause?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Splenic vein

The splenic vein runs along the posterior surface of the body and tail of the pancreas, so pancreatitis can thrombose it. Splenic blood then drains retrogradely through the short gastric and gastroepiploic veins, producing isolated gastric varices and splenomegaly (left-sided or sinistral portal hypertension). Splenectomy is curative.

Option by option

  • A. Superior mesenteric vein

    Superior mesenteric vein thrombosis causes mesenteric ischaemia, not isolated gastric varices.

  • B. Inferior mesenteric vein

    The inferior mesenteric vein drains into the splenic or superior mesenteric vein, and its occlusion alone would not cause fundal varices.

  • C. Splenic vein (correct)

    Correct. Splenic vein occlusion causes isolated gastric varices with a normal portal vein and liver.

  • D. Hepatic veins

    Hepatic vein thrombosis causes Budd-Chiari syndrome with hepatomegaly and ascites.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More Anatomy questions

Questions about this Anatomy question

What is the answer to this Anatomy question?

The best answer is C, Splenic vein. The splenic vein runs along the posterior surface of the body and tail of the pancreas, so pancreatitis can thrombose it.

Why is "Superior mesenteric vein" not the answer?

Superior mesenteric vein thrombosis causes mesenteric ischaemia, not isolated gastric varices.

Why is "Inferior mesenteric vein" not the answer?

The inferior mesenteric vein drains into the splenic or superior mesenteric vein, and its occlusion alone would not cause fundal varices.

Why is "Hepatic veins" not the answer?

Hepatic vein thrombosis causes Budd-Chiari syndrome with hepatomegaly and ascites.

What concept does this question test?

It tests Abdomen: splenic vein and pancreas in Anatomy. Splenic blood then drains retrogradely through the short gastric and gastroepiploic veins, producing isolated gastric varices and splenomegaly (left-sided or sinistral portal hypertension). Splenectomy is curative.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Abdomen: splenic vein and pancreas?

Learn every nerve by its route, its muscles and what a lesion looks like at the bedside. That one habit answers a large share of questions. Then use the flashcards and the other Anatomy questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.