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All of the following are true about the blood supply to the liver, except
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A. The portal vein is formed by the confluence of the splenic and superior mesenteric veins at the level of the second lumbar vertebra behind the head of the pancreas.
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B. The common hepatic artery arises from the celiac axis, ascends in the hepatoduodenal ligament, and gives rise to the right gastric, gastroduodenal, and proper hepatic arteries.
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C. In the hepatoduodenal ligament, the portal vein lies dorsal and slightly medial to the common bile duct.
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D. A replaced right hepatic artery typically arises from the inferior mesenteric artery and courses posteriorly and to the right of the common bile duct within the porta hepatis.
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E. A replaced left hepatic artery typically arises from the left gastric artery.
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D. A replaced right hepatic artery typically arises from the inferior mesenteric artery and courses posteriorly and to the right of the common bile duct within the porta hepatis
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The Child–Pugh classification of functional status in liver disease does not include
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Blunt trauma to the liver
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A. Requires operative management in 85% of patients
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B. With a laceration 4-cm deep but not affecting the major vasculature is a Grade III lesion
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C. Is involved in approximately 20% of all trauma admissions
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D. Is more common in the left liver than the right
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E. Is best evaluated acutely by MRI to define the ductal anatomy
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B. With a laceration 4-cm deep but not affecting the major vasculature is a Grade III lesion
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A. In the United States, is most often caused by cirrhosis
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B. Is defined as a hepatic venous pressure gradient (the difference between portal-vein pressure and hepatic-vein pressure) greater than 25 mm Hg
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C. Is caused by Budd-Chiari syndrome in about 25% of cases in the United States
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D. Due to hepatic venous thrombosis causes isolated splenic venous hypertension (sinistral or left-sided portal hypertension)
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E. Requires operative management in most patients
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A. In the United States, is most often caused by cirrhosis
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Management of acute bleeding from esophageal varices
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A. Can include transecting and anastomosing the mid-esophagus with an end-to-end stapler
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B. Should include urgent operation in most patients
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C. Should include controlling hemorrhage as expediently and simply as possible
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D. Is commonly required in the management of chronic pancreatitis
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E. Should reserve invasive procedures for patients who have required more than 15 units blood transfusion
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C. Should include controlling hemorrhage as expediently and simply as possible